Glucagon-like peptide-1 (GLP-1) can maintain glucose homeostasis, improve islet function,delay and even reverse deterioration of type 2 diabetes by several pathways.But shortly after secreting and releasing into the blood, endogenous intact GLP-1 is cleavaged by dipeptidyl peptidase-4 (DPP-4) into inactive forms.DPP4 inhibitors prevent the inactivation and enhance the physiological effects of GLP-1 through selectively suppressing the enzymic activity of DPP-4, resulting in reduction of HbA1C, fasting and postprandial plasma glucose in type 2diabetes mellitus.The favorable efficacy, safety, and tolerability of DPP-4 inhibitors, which have been well verified in numerous clinical trials and clinical practice for type 2 diabetes mellitus, render them a novel type of oral antidiabetic drugs.

Transport of gossypol by rat cauda epidldymis has been studied using microperfusion technique. It was found that gossypol entered ep-ididymal duct at very much limited rate in spite of its high plasma level. There was no difference between the aqueous & liposome formulations of gossypol to get into the epididymal duct from the blood. Since it was indicated in a previous paper that the transport rates of the 2 gossypol formulations via the blood-testis barrier were quite different. It is suggested that the transfer mechanism in test-is & epididymis may be different.

Objective To present the experience of repairing advanced scrotal hypospadias with the combined use of tubed transverse preputial island flap (Duckett) and inversed scrotal raphe flap urethroplasty. Methods 19 cases were operated on with repairing distal urethral tube by Duckett preputial island flap and scrotal raphe flap urethroplasty with suturing together the adjoining ends of the two tubes on an oblique plane.The age of the patients ranged from 2 to 12 years. The length of urethroplasty was 5～9 cm. Results All the cases were followed up for 6 months to 4 years. 17 cases recovered fully on one stage operation. 2 were complicated by urethral fistula. Conclusions The results are satisfactory.The use of a casing tube is reasonable and nontraumatic.

Objective To retrospectively analyze the correlation between the glucose variability and the recent prognosis of acute coronary syndrome.Methods Eight hundred and seventy-eight patients with acute coronary syndrome(ACS)were enrolled in present study,of them 298 cases had history of diabetes mellitus and 580 patients had no history of diabetes mellitus.All ACS patients were divided into 4 groups according to glucose variability [blood glucose coefficient of variation(CV)as index] or mean blood glucose during hospitalization.The baseline data,such as characteristics,clinical features,outcome and adverse event,of all patients with ACS were collected,and the mean blood glucose and glucose variability were calculated.Other indices of blood glucose,such as maximum blood glucose concentration during hospitalization(GluMax)and blood glucose concentration on admission(GluAdm)were also collected.The correlations between these variables and hospital mortality were analyzed retrospectively.Results Eighty-two patients died during hospitalization.The incidence of myocardial infarction and cardiogenic shock as well as hospital mortality in the patients with ACS increased significantly along with the elevation of both mean blood glucose and glucose variability during hospitalization(P

Objective To study the effect of proteasome on nigral degeneration and Lewy body formation. Methods By stereotaxic unilateral injection of different doses of lactacystin, a selective proteasome inhibitor, into the substantia nigral pars compacta of rats, the spontaneous and apomorphine induced contralateral behaviors of rats were observed. Nigral degeneration and Lewy body were viewed by HE staining; expressions of ? synuclein and tyrosine hydroxylase in nigral cells were investigated by immunohistochemistry. Contents of dopamine and homovanillic acid were determined by HPLC. Results There were no difference between 0 2 ?g group and control. Animals treated with 2 ?g and 8 ?g lactacystin developed progressively bradykinetic and displayed contralateral head tilting and tremor; apomorphine induced contralateral behavior was notably observed in rats of 8 ?g group; 3 weeks later, nigral degeneration were present in 2 ?g and 8 ?g groups; some of nigral cells contained acidophilic Lewy body with intense immune response to ? synuclein; the number of tyrosine hydroxylase positive cells in 2 ?g and 8 ?g groups were decreased by 68 24% ( P

Objective To analyze the clinical characteristics of dengue fever (DF) in Guangzhou Higher Education Mega Center (HEMC) in the year of 2014. Methods A retrospective analysis was carried out in the clinical data of 487 cases of DF patients. Results The incidence of DF accounted for 27.18% ( 527/1939) of the total emergeney fever cases. In 487 DF cases with detailed data, 261 were male, and 226 were female; 312 were young aged, 88 were middle aged, and 87 were old aged. For the systemic symptoms, fever accounted for 87.5%, headache 48.3%, and muscular soreness 47.6%. Cough ( 16.6%) , pharynx pain ( 16.8%) and running nose ( 10.9%) were common in respiratory symptoms; poor appetite ( 14.4%) and nausea ( 10.3%) were common in gastrointestinal symptoms. The abnormal laboratory parameters were mainly shown as WBC count ( 48.25%) and PLT count ( 41.68%) , following by creatine kinase ( CK, 39.49%) , aspartate aminotransferase ( AST, 34.12%) , and lactate dehydrogenase ( LDH, 31.96%) . Less cases had abnormal renal function. The distribution of Chinese medical syndrome types was shown as damp-heat blockage (65.7%), syndrome involving Weifen and Qifen simultaneously (23.6%), and Qi-yin deficiency (10.7%). Conclusion In the year of 2014, DF in Guangzhou HEMC occurred mainly among the youth people, the incidence of male DF was similar to that of the female DF, and DF cases usually have the primary symptoms of fever, aversion to cold, headache and muscular soreness. Bleeding is seldom seen in the DF patients, a few cases are complicated with the damage in the blood, liver and myocardium, and most of them have good prognosis.

Objective To observe the influence of triglyceride(TG),hemoglobin(HGB),total bilirubin(TBIL)and rheumatoid factor(RF)on the results of two kinds of D-dimer detection reagent assay.Methods Five samples were prepared into series with 2,4,6,8 and 10 mmol/L triglyceride by adding fat emulsion.Five samples were prepared into series with 1,2,3,4 and 5 g/L of hemolysis degree by adding hemoglobin solution.Five samples were prepared into series with 20,40,60,80 and 100μmol/L total bilirubin by adding bilirubin standard preparation.Ten samples were prepared into rheumatoid factor levels be-tween 0~150 IU/L by adding rheumatoid factor standard solution.Simultaneously with D-dimer detection reagent and D-di-mer HS detection reagent for testing,each sample was measured two times and the results averaged.Results When TG≤2 mmol/L,the D-dimer reagents without interference,and TG≥4 mmol/L,the D-dimer reagents due to “SD baseline data out of range”couldn’t be detected.TG≤10 mmol/L,for D-dimer HS reagents was without interference.When HGB≥1 g/L, the D-dimer reagents due to“SD baseline data out of range”couldn’t be detected.HGB≤4 g/L,for D-dimer HS reagents was without interference.When hemoglobin levels was equal to 5 g/L,the D-dimer HS reagents test results false increased about 30.4%.With total bilirubin concentration increases,D-dimer and D-dimer HS reagents test results were false increase, showed amplitude by a power law,and the two reagents increased consistency.Preparation a series of pooled plasma of rheu-matoid factor levels in 0~150 IU/L,D-dimer test results reagent falsely elevated levels of rheumatoid factor with a linear correlation (Y=59.31X+50.43,R2=0.998).When RF≤150 IU/L,the D-dimer HS reagents was without interference. Conclusion Triglyceride,hemoglobin,total bilirubin and rheumatoid factor may interfere D-dimer testing process,icterus and severe hemolysis will interfere D-dimer HS testing process.D-dimer HS reagents against interfere exceed D-dimer rea-gents.When D-dimer test results does not match with clinicians determine,the influence ofinterfering substances should be considered.

s correlated with coronary disease. Examining these peripheral arteries, more efficient in combination, seems to be a helpful way for screening coronary disease.

Objective To investigate the appropriate waist circumference (WC) cutoff points for central obesity in the middle-aged and elderly Beijing residents by the metabolic syndrome definition of the International Diabetes Federation (IDF). Methods A total of 2,344Beijing residents aged ≥40 years were investigated. They answered questionnaires, received physical examinations, and underwent plasma glucose and lipid profile measurement. Those non-diabetic subjects underwent a 75g oral glucose tolerance test. All data were analyzed to calculate the appropriate WC cutoff points for central obesity reaching the diagonsis of MS. Results 1) Both in males and females, the triglyceride (TG), systolic blood pressure, diastolic blood pressure and fasting plasma glucose (FPG) increased linearly with WC, and the high density lipoprotein cholesterol (HDL-C) decreased linearly with WC (P＜0.05). 2)The prevalence of elevated TG,reduced HDL-C, elevated blood pressure, elevated FBG, or ≥ 2 of these factors increased with WC (P＜0.05). 3) Based on the receiver operating characteristic (ROC) curve analysis and Youden index, the WC values for central obesity and for detecting BMI ≥ 25 kg/m2were about 90 cm for men and 80 cm for women. 4) The odds ratio for the presence of two or more metabolic risk factors increased abruptly in men with WC ≥ 90 cm and in women with WC ≥ 80 cm. Conclusions The appropriate WC cutoff point for central obesity was determined to be 90 cm for men and 80 cm for women in the middle-aged and elderly Beijing residents by the metabolic syndrome definition of IDF.

Objective To improve the positivity for insulinoma localization by imaging before surgery.Methods The clinical data of 119 patients with insulinoma who had been admitted to Chinese PLA General Hospital from January 1985 to April 2008 were retrospectively reviewed. Results One hundred patients with hypoglycemia who had been operated and most of them (98/100) diagnosed as insulinoma pathologically were analyzed. They had undergone various methods of localization by imaging before surgery. The positive rates for tumor localization were 22.9% (17/74) by uhrasonography (US), 55.2% (48/87) by CT, 58.8% (10/17) by MRI,76.6% (49/64) by digital subtraction angiography (DSA) ,93.3% (42/45) by endtoscopic ultrasonography (EUS)and 94.7% (18/19) by uhrasonic contrast (UC). While the rates of accuracy for tumor localization were 88.2% (15/17) by US ,87.5% (42/48) by CT, 90.0% (9/10) by MR1,100.0% (49/49) by DSA, 85.7% (36/42) by EUS and 83.3% (15/18) by UC. The rates of accuracy in patients with one,two and three positive images were 88.9% (24/27), 96. 9% (32/33) and 94. 7% (18/19), respectively. The positive rates in patients with combination of two images were 47.6% (30/63) by CT and US ,75.5% (40/53) by CT and DSA ,89.2% (33/37)by CT and EUS,90.0% (27/30) by EUS and DSA ,78.6% (11/14) by DSA and UC ,92.3% (12/13) by CT and UC, and 90.9% (10/1 i) hy EUS and UC, respectively. Conclusion The positive rates and accuracy of localization for insulinoma were increased by combining at least two images, and the combinations of any two of four images including CT, DSA, EUS and UC are suggested. While considering both the cost and effect, we recommend CT combined either with EUS or UC.