The efficacy and safety of pioglitazone in combination with insulin in type 2 diabetic patient were evaluated. CENTRAL, MEDLINE, EMBASE, CBM, CNKI(up to September 2014) were searched by computer. The quality of included randomized controlled trials(RCTs)was assessed according to the Cochrane Collaboration system review, and then meta-analysis was performed using Stata 12. 0. A total of 9 RCTs were included. The results of meta-analyses showed that HbA1C value was lower in the group taking pioglitazone plus insulin than in the group taking insulin without pioglitazone[standard mean difference -0. 48, 95% CI( -0. 55, -0. 40),I2 = 0. 0% ,P = 0. 531], but there were more patients with hypoglycaemic in the pioglitazone plus insulin groups than with insulin without pioglitazone[relative risk 1. 33, 95% CI(1. 21, 1. 46), I2 =75. 4% , P=0. 00].

With the increasing incidence of pelvic fractures, the concept of damage control was applied to the treatment of severe pelvic fractures, and the principle of phased treatment and indications were put for-ward. Meanwhile, the development of damage control surgery, which improves the survival rate and reduces the disability rate of patients, brings the treatments of pelvic fractures to a new stage.

This summary is aimed to study the virtue,operative technique and curative effect for lumbar intervertebral disc herniation (LIDH) using self-fixation intervertebral disc endoscopy. A total of 520 LIDH patients accomplishing nucleotomy with self-fixation intervertebral disc endoscopy were adopted in the experiment,including 340 males and 180 females. Their courses of disease arranged from 4 months to 10 years (17.6 months average),and follow-ups for 4-12 months. The curative effect was evaluated according to uniform standard. The curative effects were excellent in 455 cases,good in 53 cases,poor in 10 case,and the better effect rate reached 98.2%. Dura mater laceration and cerebrospinal fluid leak happened in 3 cases,coccygeal nerve damage resulting in leg numbness appeared in 1 case. Those cases all received operations at the early stage,and there were no similar complication or infection presenting in intervertebral gap. Self-fixation intervertebral disc endoscopy has the characteristics of mini-invasion,handling facility and quick postoperative recovery,so as to be suitable for the treatment of single segmental LIDH. Additionally,it plays an impact on the cases with local spinal stenosis,osteophyma hyperplasia,lateral crypt constriction and nerve canal constriction.

Aim To study tumor suppressor gene OPCML,DAPK methylation changes during the process of CasKi cell apoptosis induced by trichosanthin, and to explore the correlation and the role between cervical cancer cell apoptosis and tumor suppressor gene methylation so as to find new demethylation drugs.Methods ① MTT was applied to assay the inhibition of TCS to CasKi cell proliferation and flow cytometry was used to analyze cervical CasKi cell apoptosis induced by trichosanthin; ② Methylation-specific PCR(MSP) technology was applied to detect cervical cancer and during cell apoptosis process OPCML and DAPK gene promoter methylation status of CpG islands.Results In CasKi cervical cancer cells,OPCML and DAPK gene promoter region showed a high degree of CpG island methylation status, by trichosanthin treatment,the growth of CasKi markedly was inhibited, and flow cytometry analysed the characteristic sub-G1 peak,OPCML and DAPK gene promoter region showed no CpG island methylation of performance.Conclusions During the process of CasKi cell apoptosis induced by trichosanthin,OPCML and DAPK gene demethylated significantly,accordingly, trichosanthin might be a new methylation inhibitor,and there might be some correlation between cell apoptosis and tumor suppressor gene methylation.And OPCML and DAPK gene methylation tests might become new clinical indicators for the early detection of cervical cancer.

Histone deacetylases inhibitors(HDACIs)are a group of compound regulating gene expression at transcriptional level.HDACIs can induce protein hyperacetylation and subsequently lead to chromatin remodeling,cell-cycle arrest,cell differentiation and apoptosis,and transcriptional activation and repression.HDACIs demonstrate promising antitumor activity and are presently tested in clinical studies for solid and hematologic malignancies.Cumulating evidence in animal models of immune disorders also suggests immunosuppressive properties of HDACIs,which provides us with new ideas for treating immune disorders and rejection after transplantation.This paper reviews the recent progress of immunosuppressive function induced by HDACIs from the following aspects:immune diseases,T lymphocytes,inflammatory cytokines and dendritic cells.

The key reason for reparative process interruption of femoral head necrosis is the formation of hardening layer, which make it hard for medicine to act on the necrosis center. The research on formation mechanism of hardening layer is limited and the reason for reparative process interruption is unknown. Based on lots of pathological section and literature data, four hypotheses about the reason for reparative process interruption are proposed, including resource competition, damage of stress, disturbance of nerves and stasis of blood vessel. The internal mechanism of incomplete reparation and chronicity of hardening layer was analyze from different aspects. The four hypotheses provides a new thinking for study the reason for reparative process interruption.

Objective To discuss the effects of vitamin C in vitro,on human cancer HeLa cell multiplication and apoptosis, in order to promote vitamin C in the tumor treatment application. Methods the morphology changeof cervical cancer Hela cell was observed under the inverted microscope;the effects of vitamin e on Hela cell by MTT assay; cell cyele and weakly perishing rate was analysed rate was analysed by Flow CytoMeter;applying the agarose gelatin electricity swims to analyse weakly perishes in the process the cell gene group DNA change. Results Vitamin C hinders the HeLa cell by the density and the time dependence way to the G0/G1 period, suppresses it to grow and to induce weakly perishes. Conclusions Vitamin C may suppress the HeLa cell to grow, causes the cell to hinder to the G0/G1 period and induces cell weakly perishing.Its reason possibly was HPV E6 protein expression surrenders to restoring the function of P53 gene.

Objective To investigate and compare cytotoxic effects of cyclosporine A (CsA) treatment in kidney tubule epithelium cells (NRK-52E cells), and whether apoptosis is involved in the CsA-induced toxicity. Methods NRK-52E cells were cultured at 37?℃ in 95?% O 2/5?% CO 2, and were treated with different concentrations of CsA for 48?h.. The damage induced by CsA was characterized by an early cell detachment from culture (by direct counting of adherent cells), lactate dehydrogenase (LDH) release, and the changes in morphology were also observed by a phase-contrast microscope. Assay of apoptosis was done by TUNEL staining. Results CsA treatment induced significant damage in NRK-52E cells, which was demonstrated by obvious signs of cell injury with changes in cell shape, aggregates, and cell loss. A time- and dose-dependent increase in LDH release was also observed for CsA treatment . More than 70?% of the NRK-52E cells treated with 20??g/ml CsA for 48?h were dead. The apoptotic DNA fragments were observed in a population of NRK-52E cells treated with CsA by TUNEL staining, which represented the capacity of CsA to induce apoptosis in NRK-52E cells. Conclusions CsA treatment induced a time- and dose-dependent damage in NRK-52E cells, in which the apoptotic DNA fragments were also observed by TUNEL staining. Thus, the results obtained from the present study suggested that apoptosis, as a possible mechanism, might be involved in the CsA-induced tubulopathy.

OBJECTIVE: To understand the research on the development and application of non-fusion inter-spinous stabilization devices.DATA SOURCES: Using the key terms of "inter-spinous and low back pain", relevant articles on non-fusion inter-spinous stabilization devices and low back pain in English were retrieved from Medline between January 1966 and October 2004 and the Ovid database between January 2003 and June 2007.STUDY SELECTION: Titles and most abstracts of all articles on the types of non-fusion inter-spinous stabilization devices and action mechanisms of non-fusion inter-spinous stabilization devices were selected. Duplicated researches and meta analytic papers were excluded.DATA EXTRACTION: A total of 351 articles met the inclusion criteria and 322 were excluded. Among them, 29 papers were analyzed. The major exclusion factor was duplicate studies.DATA SYNTHESIS: Non-fusion inter-spinous stabilization devices can improve mechanism of low back pain and cause certain effects on the biodynamic environment of degenerative lumbar vertebrae, such as relieving loading of the posterior border of the anulus fibrosus of the intervertebral disc and opening the intervertebral foramen. At present,non-fusion inter-spinous stabilization devices, such as X-STOP, Wallis and DLAM, have been tested for a long time;therefore, the effects of their effectiveness, utility and risk of complications will be proved by clinical experiments as soon as possible.CONCLUSION: Non-fusion inter-spinous stabilization devices have good effects on the treatment of degenerative low back pain originating in the anulus fibrosus of the intervertebral disc and can reduce complications caused by the fusion technique.

OBJECTIVE: To investigate the selections of radionucide and vehicle and the indications, contraindications, complications and cautions of radiation synovectomy in clinical applications; meanwhile, to provide valuable references for clinical application of radiation synovectomy.DATA SOURCES: Of 277 articles which have the word "radiation synovectomy" or "radiosynovectomy" were searched out from PubMed database without limitations.STUDY SELECTION: All the titles and most abstracts of the articles were reviewed. A total of 58 articles were selected by the standard of having close relations with radionucide, vehicle and radiation synovectomy. Then the full texts were searched in other available databases, especially in "OVID" and "ScienceDirect".DATA EXTRACTION: The last articles and articles published in authority journals were chosen for further read, and 41 articles were obtained.DATA SYNTHESIS: Recently, the hot topic of radionucide is detailed as follows: Firstly, selection of vehicle. Till now, silicate, citrate, Ca oxalate, ferric hydroxide macroaggregate (FHMA), hydroxyapatite (HA), polylactic acid (PLA), sulfur colloids, microspheres, etc. Have been the most widely used vehicles. The usage of a good vehicle is to control the size and stability of the radiopharmaceutical, and decrease its leakage from the joint. Secondly, it should contain radiopharmaceuticals of nuclein and vehicle. An ideal radiolabeled radiopharmaceutical for radiation synovectomy should meet the following requirements: ① it should be sufficiently small to be phagocytized, but not so small that it might leak from the joint before being phagocytized, the appropriate size range is usually considered to be from 2 to 10 μm; ② the binding between the radionuclide and the vehicle should be irreversible throughout the course of the radiotherapy, which, in turn, is determined by the physical half-life of the radionuclide; ③ the radiolabeled particles should be distributed homogeneously in the joint without initiating an inflammatory response; ④ the half-life of the vehicle should be longer than that of the nuclide it combines,and the vehicle should be biodegradable, so that it can be eliminated out of the body after therapy; ⑤ good stability and low cost are also very important features. Thirdly, Radiation synovectomy is an effective method to treat chronic arthritis.CONCLUSION: With careful nuclide and indication selection and correct operation, radiation synovectomy is a clinically useful, safe, and cost-effective outpatient procedure in the treatment for many kinds of joint disease.