The sulfonylureas as insulin secretagogues,have formed a cornerstone of pharmacotherapy for type 2 diabetes over 50 years.Although sulfonylureas are effective antihyperglycemic agents,individual variability exists in drug response (i.e.,pharmacodynamics) and adverse effects which may be related to some genes.This article mainly reviews the advance of recent studies about drug metabolism and pharmacogenomics of sulfonylureas.

Objective To observe the efficacy of CT guided implantation of iodine 125 particles combined with high-frequency hyperthermia in the treatment of the advanced lung cancer .Methods From 2011 November to 2013 March ,60 patients with ad-vanced lung cancer were randomly divided into treatment group :high frequency hyperthermia combined with iodine 125 particle im-plantation(30 cases) ,the control group :the iodine 125 particle implantation group(30 cases) .Thermotherapy was performed 3 -5 days after the implantation using NRL-004 type hyperthermia instrument made by Jilin Maida company in China ,every other day once time ,a total of six times ,60 minutes each time .The iodine 125 particle implantation was performed according to the treatment planning system(TPS) formulation by CT guided and the dosage was 90 Gy .The evaluation of treatment effect was conformed by CT scans after two months of treatment .The side effects was assessed too .Results The total effective rate was 96 .7% in the treatment group ,the control group was 80 .0% ,there was a statistically significant difference (P< 0 .05) .The local pain in chest wall remission rate was 75 .0% (6/8) and 50 .0% (5/10) in the treatment group and the control group(P>0 .05) .The side effects of the treatment was slight including pneumothorax and particle migration and so on .Conclusion Iodine 125 particles implantation is an effective treatment in the treatment of advanced lung cancer and can obtained better effects combined with high-frequency hy-perthermia .The side effects of the treatment is slight for two groups and no death related treatment .

Objective To study the diagnosis and treatment of renal cell carcinoma. Methods 369 cases of renal cell carcinoma were reviewed for their incidence,diagnosis,treatment and prognosis. Results 281 cases(76.2%) were clear cell carcinoma ,39 cases (10.6%) of granular cell carcinoma,42 cases(11.4%) being a combination of the above two varieties and 7 cases being of other cell types. Radical nephrectomy was performed for 301 cases (81.6%) and other procedures for 45 cases. 297 cases have been followed up:three-year,five-year and ten-year survival rates were 74.6%、56.2% and 28.2% respectively. Conclusions B type ultrasonography and computerized tomography (CT) are important means in the diagnosis of renal cell carcinoma.The most effective treatment is radical nephrectomy at early stage,wherea sbiological treatment works in certain degree.

Objective To explore the clinical characteristics and diagnosis of mycoplasma pneumoniae(MP) pneumonia showing lobar pneumonia.Methods Patients from Jan.2004 to Dec.2005 were selected as researching case,which had samptoms and signs of respiratory in clinic,the chest Xray shown lobar pneumonia,the MP of down respiratory′s secretion detected by polymerase chain reaction(PCR) and MP-IgM of serum detected by indirect hemagglutination were positive.The clinical data of them were reviewed.Results MP pneumonia showing lobar pneumonia was same to streptococcus pneumoniae pneumonia in clinic,but it had some characters:1.majority of the lobar MP pneumonia were children being student;2.the process was long,the samptoms of respiratory was tipical,the continuous fever was few,and the infectious samptoms was not obvious as streptococcus pneumoniae pneumonia;3.the injury to lung was more and tipical;4.the increase of white blood cell,neutrocyte and C-reactive protein were not clearly as to streptococcus pneumoniae pneumonia,but the absorbing of lung′s focal was relatively fast;5.the ?-lactams antibiotic was not effective,but macrolides was effective.Conclusions Clinical characters of MP pneumonia are needed to master,the variety of chest X-ray changes and differentiate from other pneumonia infected by other are needed to notice.

Bone marrow microenvironment is a complex network consisting of hematopoietic stem/pro-genitor cells (HSPCs),non-hematopoietic cells,extracellular matrix and various cytokines.Its components interact to support normal hematopoiesis.Emerging evidence indicates that the dysfunction of mesenchymal stem cells,myeloid-derived suppressor cells,cytokines and the epigenetic alterations of HSPCs in the bone marrow microenvironment could influence normal hematopoiesis.Abnormal hematopoiesis contributes to the occurrence of hematological malignancies,such as myelodysplastic syndromes (MDS).Animal models have confirmed that bone marrow microenvironment plays an important role in the original generation and maintenance of malignant diseases of hematopoietic system.

OBJECTIVETo evaluate the effects of Attractin (Atrn) silence on the anti-oxidative and anti-apoptotic abilities of TM4 Sertoli cells and its influence on the expressions of superoxide dismutase (SOD) and caspase6 in the cells.

METHODSWe observed the apoptotic indexes of TM4 Sertoli cells with normal expression (control), partial deletion, and complete deletion of the Atrn gene (psiRNA-TM4, psiAtrn-TM4, and mu-SC). We determined the mRNA and protein expressions of SOD and caspase6 by Q-PCR and Western blot, measured the SOD activity and malondialdehyde (MDA) contentby spectrophotometry, and detected the apoptotic index of the cells by TUNEL.

RESULTSCompared with psiRNA-TM4, after inhibition of the Atrn expression, the Sertoli cells in the psiAtrn-TM4 and mu-SCgroups showed significantly decreased expressions ofSOD mRNA (70.76% and 92.58%) and protein (65.11% and 71.0%) (both P < 0.05). The levels of caspase 6 mRNA and protein were increased 5.28 and 3.40 times in the psiAtrn-TM4 and 2.97 and 2.50 times in the mu-SCgroup as compared with the normal control (both P < 0.05). Atrn deletion markedly increased the apoptotic indexes of the cells in the psiAtrn-TM4 and mu-SC groups by 16.22% and 22.03% (P < 0.05) and reduced the activity of SOD by 23.00% and 39.37% (P < 0.05); it also elevated the level of MDA by 155.22% (P < 0.05).

CONCLUSIONThe Atrn gene exerts influence on the function of Sertoli cells in multiple ways, in which antioxidative stress and apoptosis regulation may play an important role.

Animals ; Apoptosis ; Caspase 6 ; metabolism ; Cells, Cultured ; Gene Deletion ; Male ; Membrane Proteins ; genetics ; metabolism ; Mice ; Oxidative Stress ; Sertoli Cells ; metabolism ; pathology ; Superoxide Dismutase ; metabolism

Objective To survey the CT radiation dose to cancer patients,and to compare it with diagnostic reference level (DRL) provided by newly issued national standard.Methods Computed tomography dose index weighted (CTDIw) of 5 CT equipments was measured by the standard phantom with typical scanning protocol and radiation dose parameters including average computed tomography dose index volume (CTDIvol),dose length product (DLP),75％ DLP with 900 adult and 300 pediatric cancer patients were collected.According to age stage,effective dose was estimated.Results The measured CTDIw for head scanning was on the same level with DRL,while lumbar vertebra and abdominal scanning were lower than DRL.To adults,DLP of cerebrovascular enhanced scanning and effective dose of abdominal enhanced scanning were the highest.To pediatric patients,there was no significant difference in DLP among different ages.Conclusion CTDI only reflects the dose contribution from a slice,but do not reflect the cumulative dose.For the patients need multiphase scanning,because they may be exposed to high dose,national standard should provide DLP value as the diagnostic reference level.Using individual scanning protocol is an effective method to reduce radiation dose of pediatric patient.

Objective To investigate the clinical features ,diagnosis and treatment of cesarean scar pregnancy (CSP) .Methods We retrospectively analyzed the medical history ,clinical manifestation ,diagnoses ,treatments and outcomes of 42 patients with ec‐topic pregnancy in the cesarean scar .Results All cases got diagnosed by transvaginal ultrasound .The error rate of first diagnosis was 40 .4% (17/42) .There were 25 cases of conservative therapy ,in which 12 cases were resolved with laparoscopic surgery and 1 case resolved with open surgery ;in the first process 15 cases were carried out laparoscopic surger in which 1 case were converted to laparotomy ;abdominal surgery were underwented in 1 case and were cured .Only one case underwent abdominal total hysterectomy as of failure after uterine artery embolization .After initial conservative treatment 3 cases were hospitalized again and 2 cases under‐went reoperation .41 patients were successfully retained the uterus and normal menstrual cycle returned at two months after opera‐tion .Conclusion The early diagnosis for CSP mainly depended on ultrasound and the thickness of incision muscle layer is an impor‐tant basis for choice of treatment .Checking the thickness of incision muscle layer for CSP mainly depended on ultrasound ,and lapa‐roscopic surgery is an ideal method for diagnosis and treatment of CSP .

OBJECTIVETo discuss the mechanism of gambogenic acid (GNA) in inducing the apoptosis of melanoma B16 cells.

METHODThe inhibitory effect of GNA on the proliferation of B16 cells was measured by the methyl thiazolyl tetrazolium (MTT) assay. The effect of GNA on B16 cells was detected by the Hoechst 33258 staining. The transmission electron microscopy was used to observe the ultra-structure changes of B16 cells. The changes in PI3K, p-PI3K, Akt, p-Akt, p-mTOR, PTEN proteins were detected by the Western blotting to discuss the molecular mechanism of GNA in inducing the apoptosis of B16 cells.

RESULTGNA showed a significant inhibitory effect in the growth and proliferation of melanoma B16 cells. The cell viability remarkably decreased with the increase of GNA concentration and the extension of the action time. The results of the Hoechst 33258 staining showed that cells processed with GNA demonstrated apparent apoptotic characteristics. Under the transmission electron microscope, B16 cells, after being treated with GNA, showed obvious morphological changes of apoptosis. The Western blot showed a time-dependent reduction in the p-PI3K and p-Akt protein expressions, with no change in p-PI3K and p-Akt protein expression quantities. The p-mTOR protein expression decreased with the extension of time, where as the PTEN protein expression showed a time-dependent increase.

CONCLUSIONGNA could inhibit the proliferation of melanoma B16 cells and induce their apoptosis within certain time and concentration ranges. Its mechanism in inducing the cell apoptosis may be related to PI3K/Akt/mTOR signaling pathways.

Animals ; Apoptosis ; drug effects ; Blotting, Western ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Cell Survival ; drug effects ; Dose-Response Relationship, Drug ; Melanoma ; metabolism ; pathology ; ultrastructure ; Mice ; Microscopy, Electron, Transmission ; Microscopy, Fluorescence ; PTEN Phosphohydrolase ; metabolism ; Phosphatidylinositol 3-Kinases ; metabolism ; Proto-Oncogene Proteins c-akt ; metabolism ; Signal Transduction ; drug effects ; TOR Serine-Threonine Kinases ; metabolism ; Terpenes ; pharmacology ; Xanthenes ; Xanthones ; pharmacology

Adult ; Female ; Granuloma ; etiology ; surgery ; Humans ; Male ; Middle Aged ; Postoperative Complications ; surgery ; Tracheal Diseases ; etiology ; surgery ; Tracheal Stenosis ; etiology ; surgery ; Tracheostomy ; adverse effects