Objective To investigate the clinical efficacy of DPP-4 inhibitors in the treatment of newly diagnosed type 2 diabetes mellitus and its effect on blood pressure and body weight.Methods A total of 100 newly diagnosed elderly patients with type 2 diabetes mellitus were enrolled in this study from July 2013 to June 2015 in this hospital.They were divided into observation group and control group(n=50).The control group was treated with placebo on the basis of diet control and exercise.The observation group was treated with sitagliptin on the basis of diet control and exercise.Fasting plasma glucose(FPG),2 h postprandial blood glucose(2 h PG) and glycated albumin (GA) were measured before and after treatment,and the incidence rate of hypoglycemia,blood pressure,body weight and other adverse reactions were monitored.Results After treatment,two groups of patients,condition were significantly improved,FPG,2 h PG,GA changes in observation group were significantly better than that of control group,the difference were statistically significant(P＜0.05).There was no significant difference in blood pressure,body weight and body mass index before and after treatment,and also between the two groups(P＞0.05).The incidence of adverse reactions in the observation group and the control group were 10.0％ and 8.0％,The incidence of adverse reactions in the two groups was not statistically significant(P＞0.05).Conclusion The clinical efficacy of DPP-4 inhibitor siglitazide in the treatment of newly diagnosed elderly patients with type 2 diabetes mellitus is good,and it is very useful in the treatment of these patients.

Aim Toinvestigatetheeffectofhigh,me-dium and low doses of Mahuang decoction on the re-lease amount of rat hippocampal neural transmitter (Glu,Gly,Asp,GABA),then compare Mahuang de-contion with ephedra alkaloids and ephedra.Methods Ratswererandomlydividedinto6groupsandgiven orally with Mahuang decoction of high dose (calculated by ephedra 4 g·kg-1 ),medium dose (calculated by ephedra 2 g·kg-1 ),low dose (calculated by ephedra 1 g · kg-1 ),ephedra (calculated by ephedra 2 g · kg-1 ),ephedra alkaloids (ephedrine 7 mg · kg-1 , pseudoephedrine 2. 4 mg · kg-1 , methylephedrine 1. 12 mg · kg-1 )and blank control group.Samples were obtained from the hippocampus of conscious rat by microdialysis sampling technique.The content of ami-no acid neurotransmitters in dialysates was detected u-sing the established HPLC-ECD with OPA pre-column derivationmethod.Results Fouraminoacidneuro-transmitters could be well separated in 28 min.High, medium and low doses of Mahuang decoction,ephedra and ephedra alkaloids significantly increased the con-tent of these four amino acid neurotransmitters,com-pared with blank control group (P<0. 05 ).Ephedra alkaloids significantly reduced the levels of inhibitoryamino acid neurotransmitters GABA and Gly in 90 min,compared with the medium dose of Mahuang de-coction.Excitatory neurotransmitters of ASP and Glu in hippocampus showed the trend of increase first and then decrease after oral administration of Mahuang de-coction and ephedra. The levels of Glu and Asp reached peaks from 90 min to 120 min after treatment with Mahuang decoction,and also increased along with dose increase of Mahuang decoction.In comparison with the medium dose of Mahuang decoction group,the level of Glu reached peak at 90 min and 150 min in ephedra alkaloids group and ephedra group respective-ly,and the content of Glu significantly increased at peaktime.Conclusions Increasedcontentofexcita-tory amino acid neurotransmitters (Asp and Glu ) shows positive correlation with the dose of Mahuang de-coction.Other components in Mahuang decoction in-hibits the up-regulation effect of ephedra and ephedra alkaloids on Glu,and promotes the up-regulation effect of ephedra alkaloids on GABA and Gly.

OBJECTIVE:To promote rational use of traditional Chinese medicines. METHODS:The practical importance of applying basic pharmacoeconomic theory to the rational use of traditional Chinese medicines was analyzed and the measures regarding how to apply the pharmacoeconomic theory to guide rational use of traditional Chinese medicines were put forward. RESULT & CONCLUSION: It is quite necessary and practical to apply the basic pharmacoeconomic theory to the rational use of traditional Chinese medicine, which plays a positive role in promoting rational use of traditional Chinese medicines.

Objective To investigate the importance of hepatitis B virus ( HBV ) infection in the patho-genesis of cholangiocarcinoma ( CC) and further clarify the correlation between the occurrence of intrahepatic and extrahepatic cholangiocarcinoma .Methods HBV protein and gene of 52 formalin fixed,paraffin embedded tis-sues with CC were detected by immunohistochemistry and nest PCR .Results Hepatitis B virus X gene was de-tectable in 33.3%(7/21)of 21 intrahepatic cholangiocarcinoma cases .Hepatitis B surface antigen(HBsAg)was detectable in 21.7%(5/21)and hepatitis B core antigen(HBcAg)was detectable in 19.0%(4/21)of 21 intrahe-patic cholangiocarcinoma cases .In contrast,no HBsAg,HBcAg and hepatitis B virus X gene were detected in any of the 31 extrahepatic cholangiocarcinoma cases .Conclusion HBV infection is a significant risk factor for intra-hepatic cholangiocarcinoma ,but not for extrahepatic cholangiocarcinoma ,in Northeast of China .The integration of HBV gene may be involved in the carcinogenesis of intrahepatic bile duct epithelial cells .

Objective To investigate the expression of DNMT3b mRNA and microRNA-29b (miR-29b) in pancreatic cancer cells and analyze their relationship.Methods Real-time RT-PCR method was used to detect the expression of DNMT3b mRNA and miR-29b in five pancreatic cancer cell lines ( PANC1,BxPC3,CFPAC,AsPC 1,Capan 2 ) and the relationship between DNMT3b mRNA and miR-29b expression was analvzed by pearson linear correlation method.Results The expression of DNMT3b mRNA in PANC1,BxPC3,CFPAC,AsPC 1,Capan 2 were 0.497 ±0.184,0.420 ±0.168,0.439 ±0.217,0.122 ±0.111 and 0.731 ±0.387,while the expression of miR-29b were 0.745 ± 0.596,0.797 ± 1.000,0.464 ± 0.430,1.836 ± 1.623 and 0.216 ± 0.335.The expression of DNMT3b mRNA was negatively correlated with the expression of miR-29b (r =-0.922,P =0.026 ).Conclusions Both DNMT3b and miRNA29b are involved in the carcinogenesis of pancreatic cancer,and they are negatively correlated.

Objective To compare the efficacy and safety of E1B gene-deleted adenovirus (H101)and ethanol in treating advanced pancreatic carcinomas by intratumoral injection combined with intravenous gemcitabine.Methods We constructed an orthotopic nude mouse model of pancreatic carcinoma through cancer cell injection into pancreas.A total of 54 nude mice were randomly allocated to 6 groups to accept H101,ethanol or saline (control) intratumoral injection,combined with or without intravenous gemcitabiein.The animals were sacrificed 4 weeks after the treatment and the pancreatic tumors were collected to determine the size,existence of metastasis,distribution of virus by indirect immunofluorescence and apoptosis in tumor by TUNEL and electron microscope.Results All mice completed the scheduled treatment,while 3 died in 48 hours after ethanol injection resulting in a mortality of 16.7％ (3/18).On the contrary,no mice died in the adenovirus injcction group.The average tumor size in group of H101 intratumoral injection combined with intravenous gemcitabie was significant smaller than that in group of saline injection with or without systemic gemcitabie (P =0.008,0.040,respectively).Similar differences were observed between ethanol intratumoral injection and control groups (P =0.012,0.041).Meanwhile,the H101 was absent in all the other organs except the pancreas,which meant that the selectivity of the H101 was tremcndous.The virus combine gemcitabie group had higher apoptosis rate in tumor (83.2 ± 35.7) ％,determined by TUNEL.Conclusion E1B gene-deleted adenovirus intratumral injection in combination with intravenous gemcitabine treating pancreatic carcinomas is efficient and safe,in spite of its lower effectiveness than ethanol.

Objective To evaluate the efficacy and tolerability of EUS-guided intra-tumoral injection of E1B gene-deleted adenovirus (H101) combined with intravenous gemcitabine for unresectable pancreatic carcinomas. Methods Nineteen patients with advanced adenocarcinoma of the pancreas who were not resectable and never to anti-cancer treatment were enrolled in this study. Each patient underwent two sessions of EUS-guided H101 intra-tumoral injection in combination with gemcitabine (i. v. , 1000 mg/m2, d3, 10, 17). The tumor size before and after H101 intra-tumoral injection were recorded for efficacy assessment. The changes of pain score and KPS, adverse effects and complication rates, survival were estimated. Results The tumor size decreased in twelve patients by5.3% ~ 69.7% , but the difference was not statistically significant (P =0.275). All of nineteen patients completed two cycles of combination treatment. Among them, 3 (15. 8% ) achieved partial response, 10 (52.6% ) had stable disease, and none had complete response. The mean pain score after injection was significantly lower than that before injection (3.1 ±1.7 vs. 3.9±1.6, P = 0.004). KPS after injection was significantly increased more than that before injection [ (68.4 ± 12.1)% vs. (61.1 ±9.9)%, P =0.003)]. There was no complication associated with the procedure. Major adverse effects associated with H101 injection were fever and diarrhea. The survival time was 2.5 to 10 months. Nine patients were still alive. Conclusions EUS-guided E1B gene-deleted adenovirus intra-tumral injection in unresectable pancreatic carcinomas is feasible and well tolerated in combination with intravenous gemcitabine, which can improve the quality of life and decrease the pain score.

Objective To investigate the clinical benefit response (CBR) in treating the unresectable pancreatic carcinoma by applying the EUS guided iodine-125 seed implantation combined with chemotherapy of gemeitabine and comparing chemotherapy of gemcitabine alone. Methods Forty-one patients with unresectable pancreatic carcinoma were randomly divided into two groups, one group (Group A) included 21 cases which underwent EUS-guided iodine-125 seed implantation combined with gemcitabine chemotherapy, the rest 20 cases (Group B) were treated with gemcitabine chemotherapy alone. EUS-guided iodine-125 seed implantation were carried according to the treatment plan system (TPS), following chemotherapy after 1 week. Gemcitabine was administered at the dose of 1 000 mg/m2, through intravenous administration once a week for 3 consecutive weeks every 4 weeks. CBR was assessed. Results CBR of Group A was 57.1% and median time to CBR was 1 week and median duration of CBR was 21 weeks, while CBR of Group B was 25%, and median time to CBR was 4 weeks and median duration of CBR was 15 weeks (P<0.01). Conclusions EUS-guided iodine-125 seed implantation combined with chemotherapy of gemcitabine was superior to gemcitabine chemotherapy alone in the term of CBR in patients with unresectable pancreatic carcinoma.

Objective To investigate the expression of miRNAs in endoscopic ultrasound (EUS)-guided fine needle pancreatic aspirates (FNA) and its clinical significance. Methods The expression of miRNA-210, miRNA-21, miRNA-196a, miRNA-181a, miRNA-181b, miRNA-155 and miRNA-16 in EUS-FNA specimen of 23 pancreatic cancer and 13 benign pancreatic masses was detected with quantitative real-time polymerase chain reaction (qRT-PCR) assays and its clinical significance was analyzed. Results The relatively expression quantity of miRNA-210, miRNA-21,miRNA-196a, miRNA-181a and miRNA-181b (0.86±1.10, 0.69±0.64, 0.32±2.50, 0.16±0.83and 0.56 ±0.88, respectively) was significant higher in pancreatic cancer than those in the benign pancreatic masses (-0.11±0.98,-0.03±0.97,-1.50±1.40,-0.53±1.10 and -0.28±1.10,respectively) (P value was 0. 012, 0. 011, 0. 024, 0. 036 and 0.015, respectively). The relatively expression quantity of miRNA-16 and miRNA-155 in pancreatic cancer and benign pancreatic masses was - 0.11 ± 0.69, 0.08 ± 1.04, - 0.73 ± 1.26 and - 0.19 ± 1.19 respectively, no statistic difference (P value was 0. 067 and 0. 467). The high expression of miRNA196a was positively correlated with pancreatic cancer lymphatic metastasis and clinical TNM staging. Conclusion There were multi miRNAs with abnormal high expression in the pancreatic cancer. Of those, miRNA-196a was associated with the clinical malignant features of pancreatic cancer.

Objective To investigate the expression of SUFU protein in human pancreatic carcinoma tissues and to explore the relationship between the expression of SUFU protein and the clinicopathologic parameters.Methods The expression of SUFU protein in 28 samples of pancreatic cancer tissues and 20 adjacent normal pancreatic tissues and 4 normal pancreatic tissues was detected by immunohistochemical method.And the relationship between the expression of SUFU protein and the clinicopathologic parameters were determined.Results SUFU protein was positively expressed in cytoplasm and nucleus of pancreatic carcinoma cells, while it was not expressed in the duct, acinar and islet of tumor-adjacent tissues and normal pancreatic tissues, and difference was statistically significant (P ＜ 0.05).The high SUFU protein expression was related to the clinical stage ( P ＜ 0.05 ), but not the age, gender, tumor location , tumor size, lymph node metastasis and liver metastasis.Conclusions SUFU protein was highly expressed in pancreatic cancer, and SUFU may play certain role in the pathogenesis of pancreatic cancer.