OBJECTIVE:To systematically review the efficacy and safety of different doses of canagliflozin in the treatment of type 2 diabetes,and provide evidence-based reference for the clinical treatment. METHODS:Retrieved from PubMed,Cochrane Library,Clinical Trails.gov,CJFD,Wangfang Database and VIP,randomized controlled trials (RCT) about different doses of canagliflozin in the treatment of type 2 diabetes were collected. Meta-analysis was performed by using Rev Man 5.3 software after data extract and quality evaluation by Cachrane 5.10. RESULTS:Totally 11 RCTs were enrolled,involving 5 399 patients. Results of Meta-analysis showed,canagliflozin 300 mg/d were superior to 100 mg/d in reducing HbA1c[MD=0.14,95%CI(0.09,0.19), P<0.001],FPG[MD=0.40,95%CI(0.20,0.61),P<0.001] and reduction rate of body mass[MD=0.69,95%CI(0.42,0.96),P<0.001],the differences were statistically significant;and there were no significant differences in the incidence of total adverse reac-tions [RR=0.97,95%CI(0.94,1.01),P=0.10],hypoglycemia [RR=1.02,95%CI(0.94,1.10),P=0.67],urinary tract infection[RR=0.96,95%CI (0.78,1.18),P=0.69] in 2 groups;There was significantly different of genital mycotic infection in 2 groups[RR=0.84,95%CI(0.70,1.00),P=0.04]. CONCLUSIONS:Canagliflozin 300 mg/d is better than 100 mg/d in controlling HbA1c,fasting blood glucose and body mass of patients with type 2 diabetes,and the genital mycotic infection should be attentioned.

Background and purpose:urokinase-typeplasminoogen activator receptor(uPAR) plays important roles in terms of fibrolysis in tissue,cell adhering prolifration and signal transduction uPAR can the detected in both cancer and matrix cells.It has been reorted that uPAR is associated with invasion and metastasis of cancer cells.This paper is to study the effects of the gene expression of uPAR and VEGF-C on onco-genesis and progression of ovarian cancer.Methods:The expression of uPAR gene protein and VEGF-C were examined immunohistochemically in 58 cases of ovarian serous cystadenocarcinoma,10 cases of borderline serous cystadenomas and 13 cases of serous cystadenocarcinoma.The relationships between the results and pathological features were studied.Results:① The expressions of uPAR in benign and malignant tumors were different significantly(P

Objective To investigate the scientific research ability and training needs of the new posts of medical undergraduates for better training them.Methods A total of 62 new posts of medical undergraduates from a level-two general hospital in China were recruited by questionnaire survey.Resuits the scientific research ability of the new posts of medical undergraduates is poor,so it is very necessary for their in-service training,93.5~ of them have interest in scientific research and hope to get the training,especially want to take part in the practical activity.Conclusions It is not better that the scientific research ability of the new posts of medical undergraduates,so as early as possible to give the scientific research skill training to them.

Aim To study the antipsychotic effects of l-Scoulerine ( l-SLR) . Methods NMDAreceptorantag-onist MK-801 was used to induce the positive and neg-ative symptoms of schizophrenia and cognitive impair-ment in animal models. The effects of l-SLR were eval-uated on schizophrenia induced by MK-801 and on ex-trapyramidal system. Results l-SLR (10,15 mg · kg - 1 , ip) could suppress pre-pulse inhibition damage in rats induced by MK-801 (0. 3 mg·kg - 1 , ip); l-SLR(30 mg·kg - 1 , ip) could inhibit climbing behav-iors in mice induced by apomorphine, which suggested that l-SLR had significant inhibiting effects on the posi-tive symptoms of schizophrenia by MK-801 and apo-morphine. l-SLR could also induce social contact inhi-bition and cognitive impairment induced by MK-801 (0. 2 mg · kg - 1 , ip), which proposed that l-SLR could improve the negative symptoms and cognitive im-pairment by MK-801. Catalepsy in mice could be caused by the treatment dose of haloperidol (0. 8 mg· kg - 1 , ip), not by that of l-SLR(30 mg·kg - 1 , ip). Conclusion I-SLR has significant effects on the posi-tive and negative symptoms of schizophrenia and cogni-tive impairment and, the effect of l-SLR under effective dose on extrapyramidal system is obviously much less than that of haloperidol and l-SPD.

Objective To summarize and analyze the clinical feature,therapeutic mnethods and prognosis of colorectal small cell carcinoma.Methods From January 2000 to January 2012,15 patients of colorectal small cell carcinoma were analyzed retrospectively.Results There were 12 male cases,3 females.The age at diagnosis was between 39-71 years,with median age of 60.SCC located in the rectum in 12 cases,in the colon in 3 cases.The time from the onset of symptoms to final diagnosis was from 1 to 12 months.The diameter of tumors varied from 2.5 to 8.0 cm.13 cases received up-front surgery,including radical tumor resection in 6 cases,palliative resection in 7 cases,and neoadjuvant-chemotherapy followed by palliative resection in one case.The initial Ⅰ,Ⅲ B,Ⅳ B stage were 1 case,6 cases and 8 cases,respectively.The overall median survival time is 11 months,1,2 year's survival rate is 40.0％ and 20.0％,respectively.Conclusions Colorectal SCC is less common and the prognosis is poor.Multimodality management,with radical surgical resection of the primary lesion followed by standard adjuvantchemotherapy,affords good local disease control and a fair survival.

Objective To compare the effects of median nerve electrical stimulation on coma patients after traumatic brain injury with different settings. Methods From 2013 to 2015, 161 patients with traumatic brain injury were randomly divided into control group (n=40), experimental group 1 (n=41), experimental group 2 (n=39) and experimental group 3 (n=41). The control group received routine conscious-ness-promoted methods, and the experimental groups received median nerve electrical stimulation with 200μs and 30 Hz, 100 Hz and 50 Hz in sequence, 60 minutes a day for 90 days. They were assessed with Glasgow Coma Scale (GCS) and Coma Recovery Scale-Revised (CRS-R) before, 30 days and 90 days after treatment. Results There was significant difference in the scores of CCS and CRS-R, times of treatment, number of sobered patients and coma time among groups (P<0.01), that the experimental groups were better than the control group (P<0.05), and no significant difference was found between the experimental groups 1 and 2 (P>0.05). The experimental group 3 was better than the experimental groups 1 and 2 (P<0.05). Conclusion Median nerve electrical stimulation with 200μs, 50 Hz could promote co-ma patients to wake up optimally.

Objective To characterize differences within facial profile esthetic evaluations among three groups of evaluators and the influences of sagittal or vertical skeletal patterns on facial profile esthetics. Methods A total of 114 silhouettes,from the pre?or post?treatment facial profiles of 57 patients,were scored by three groups of evaluators(professionals,patients'parents,and laypersons)to characterize differences within facial es?thetics evaluation among evaluators. The highest?scoring 30 silhouettes and the lowest?scoring 30 silhouettes were selected as the high score group and the low score group,respectively. Sixteen indices of the relative lateral cephalometric films were measured. Data were analyzed by SPSS 21.0. Results Facial profiles following orthodontic treatment scored higher than pre?treatment(P<0.05). There were significant differences between professionals and laypersons in facial profile scoring. Different sagittal skeletal patterns had no effect on esthetic evaluation ,but lower facial height significantly influenced whether a patient received a high or low esthetic score(P<0.05). Conclusion Orthodontic treatment can improve the fa?cial profile significantly,and lower facial height is the most sensitive index for facial profile evaluation in our study. However,all three evaluator groups have different esthetic standards that don't overlap. Notably,the expectations of laymen are higher than those of orthodontists.

Objective To investigate the characteristics of lymph nodes metastasis in papillary thyroid carcinoma (PTC) and to discuss surgical approach.Methods All patients underwent total thyroidectomy,central lymph nodes and lateral lymph nodes dissection in Department of Thyroid Surgery,the First Hospital of the Jilin University,from Dec.2011 to Dec.2012.Results With the increase of the number of positive central lymph nodes,lateral cervical lymph node metastasis rate increased as well and accompanied multi region metastasis trend.In 102 cases of lateral positive cervical lymph node patients,55 cases were in level Ⅱ,accounting for 53.92％,62 cases were in level Ⅲ,accounting for 60.78％,76 cases were in level Ⅳ,accounting for 74.51％,and 17 cases were in level V,accounting for 16.67％.In lateral lymph nodes metastasis,we found level Ⅳ was the most vulnerable area,followed by level Ⅲ,level Ⅱ and level Ⅴ.Conclusions Prophylactic central lymph node dissection should be performed in PTC patients.Patients with central lymph node metastasis especially with the number of positive lymph nodes ＞ 3 should be performed ipsilateral level Ⅱ-Ⅴ lymph node dissection.

Objective To observe the level of autophagy induced by TRAIL in TT cell line and identify the role of autophagy in TRAIL-inducing apoptosis of TT cell line.Methods The growth inhibition of TT cells was measured by MTT assay.MDC staining was used to identify the happening of autophagy.Annexin V/PI double staining was used to analyze the apoptosis rate of TT cells by flowcytometry.The protein expression of caspase-8 and Beclin1 was detected by Western blot.Results ① The growth inhibition ratio of TT cells induced by TRAIL at the concentration of 250,500,1000 and 2000 ng/ml was (3.02 ± 1.82)％,(4.87 ± 1.45)％,(7.51 ± 1.57) ％,(12.76 ± 3.23) ％ respectively,which suggested significant resistance of TT cells to TRAIL.② MDC-labeled green light vesicles was significantly increased after the treatment of TRAIL for 48 h.③ The apoptosis rate of TT cells induced by TRAIL at the concentration of 500 ng/ml and 1000 ng/ml after the pretreat ment of 3-MA for 4 h was(17.83 ± 1.54) ％ and(27.81 ± 1.79) ％ respectively,which was significantly higher than the apoptosis rate induced by TRAIL(3.70 ± 0.34) ％,(6.55 ± 0.59) ％ alone and that induced by 3-MA(7.71 ± 0.64) ％ (t =3.282,P ＜ 0.05 ; t =7.830,P ＜ 0.01).④ The combination treatment of TRAIL and 3-MA increased the cleavage of caspase-8 and down-regulated the expression of Beclin 1.Conclusion Autophagy induced by TRAIL may contributes to the resistance of TT cells to TRAIL,which can be reversed by the inhibition of autophagy.

Objective To setup a measurement of human bone marrow micromegakaryocyte which based on CD41a and PI double‐labeled flow cytometric analysis ,and study the significance in the diagnosis of MDS .Methods In 42 cases of MDS patients , their bone marrow megakaryocytes were obtained by Percoll density gradient separation medium .The megakaryocyte glycoproteinⅡb/Ⅲa(CD41a)were marked with fluorescein isothiocyanate through its corresponding monoclonal antibody ,and their DNA were marked with PI .Then the megakaryocyte ploidy was analyzed by flow cytometry(FCM ) .Results The method for micromegakaryo‐cyte identification and analysis was established .In 42 patients with MDS ,the detection rate of micromegakaryocyte was 90 .5 per‐cent by FCM analysis ,but only 54 .8 percent by Wright‐Giemsa staining test and 64 .3 percent by immunohistochemistry ,the differ‐ence among them was statistically significant(χ2 = 13 .640 ,P= 0 .001) .The 42 patients with MDS were divided into two groups (low‐risk group and high‐risk group) .The detection rates of micromegakaryocyte were 81 .8 percent in low‐risk group and 100 per‐cent in high‐risk group separately by FCM analysis ,the difference was statistically significant(χ2 =4 .019 ,P=0 .045) .Conclusion The detection rate of micromegakaryocyte by FCM with CD41a and PI double marker is higher than that by cytochemical staining . The detection rate of micromegakaryocyte in the high‐risk group is higher than that of the low‐risk group ,which shows that the de‐tection of micromegakaryocyte is of great significance for MDS prognosis assessment .