A 24-week study was performed to compare the efficacies of before and after dipeptidyl peptidase-4 inhibitor sitagliptin phosphate 100 mg/d in 42 type 2 diabetics who were inadequately controlled with multiple oral antidiabetic drugs for at least 3 months.The treatment group sitagliptin phosphate fasting plasma glucose,2 h postprandial glucose (2 hPPG) and glycated hemoglobulin decreased significantly compared with before treatment [(9.3 ±1.2) to (6.5 ±1.9) mmol/L,(15.2 ±3.1) to (8.1 ±2.1)mmol/L,(8.2 ± 2.1) ％ to (6.7 ± 1.3) ％,all P ＜ 0.01].There was no hypoglycemia,weight gain or other adverse reactions.The short-term sitagliptin phosphate could effectively reduce the blood sugar levels of poorly controlled obese type 2 diabetics.With a low incidence of hypoglycemia and an excellent safety profilc,there was no weight gain.

Seventy patients with type 2 diabetes (T2DM),23 subjects with impaired glucose tolerance (IGT) and 35 individuals with normal glucose tolerance (NGT) were recruited in the study.Fasting free fatty acids (fFFA) and postprandial free fatty acids (2 hFFA) after oral glucose tolerance test (OGTT) were measured; homeostasis model assessment of insulin resistance (HOMA-IR),area under the curve of free fatty acids (AUCFFA) were calculated.The carotid artery intima-media thickness (IMT) was assessed by color ultrasonography.HOMA-IR,fFFA,2 hFFA,AUCFFA and IMT in T2DM group were 3.3 ±3.2,(0.55 ± 0.20) mmol/L,(0.28 ±0.18)mmol/L,(0.83 ±0.34)mmol · L-1 · h-1 and (0.12±0.05) cm,which were significantly higher than those in NGT group,respectively [1.9 ± 1.3,(0.41 ±0.15) mmol/L,(0.12 ± 0.10) mmol/L,(0.53 ± 0.20) mmol · L-1 · h 1 and (0.09 ± 0.03) cm,all P ＜0.05].Both HOMA-IR and IMT were positively correlated with fFFA,2 hFFA and AUCFFA (all P ＜ 0.05).The results indicate that the levels of fasting and postprantial free fatty acid were related with insulin resistance and atherosclerosis of carotid artery.

BACKGROUND:Anti-rotation intramedulary nail fixation for proximal femoral fractures replaces the femoral bearing axis, moves towards body axis relative to hip screw and dynamic ankle screw, enhances the anti-fatigue strength at the fracture site, supports the anti-varus and prevents the rotation of the proximal fracture site, and is suitable for the treatment of unstable fracture. OBJECTIVE:To comparatively observe the effects of dynamic hip screw knife system and minimaly invasive spiral blade anti-rotation intramedulary nail in the repair of unstable intertrochanteric fractures. METHODS: A total of 82 cases of unstable intertrochanteric fractures, who were treated in the Department of Orthopedics, First People’s Hospital of Shunde from January 2012 to January 2014, were selected in this study. The patients were equaly and randomly divided into two groups: dynamic hip screw knife system group and minimaly invasive spiral blade anti-rotation intramedulary nail group. Repair index, fracture healing time and the incidence of complications were compared between the two groups. RESULTS AND CONCLUSION:Healing time and repair index were significantly better in the minimaly invasive spiral blade anti-rotation intramedulary nail group than in the dynamic hip screw knife system group (P < 0.05). Complications appeared in five patients from the minimaly invasive spiral blade anti-rotation intramedulary nail group, with the incidence rate of 12%, and in ten patients from the dynamic hip screw knife system group, with the incidence rate of 24%. The incidence of complications was significantly lower in the minimaly invasive spiral blade anti-rotation intramedulary nail group than in the dynamic hip screw knife system group (P < 0.05). These data suggest that for patients with unstable intertrochanteric fracture, minimaly invasive spiral blade anti-rotation intramedulary nail can decrease the incidence of complications, elevate the safety of the repair method, and promote the functional recovery.

Traditional Chinese medicine (TCM) Xiaoaiping shows a pharmacological activity in treatment of breast cancer. Although neoadjuvant chemotherapy has been more and more widely used in treatment of breast cancer in recent years, no report has been made about the clinical efficacy and mechanism of the combined application of neoadjuvant chemotherapy and Xiaoaiping in treatment of breast cancer. In this study, 66 patients with breast cancer were selected and divided into the control group and the treatment group evenly with the random number table method. All patients received TEC neoadjuvant chemotherapy. On that basis, the treatment group also received the adjuvant therapy of Xiaoaiping injection (60 mL, i. v. , qd). The short-term response rate and the follow-up survival rate of the two groups were observed and compared. Surgical specimens of the patient were collected to observe and compare their expressions of estrogen receptor ER-α36 in breast cancer tissues with the immunohistochemical method. According to the findings, the overall response rate of the treatment group was 78.79%, which was significantly higher than that of the control group (57.58% , χ2 = 5.48, P < 0.05). Compared with the control group, the treatment group showed significant increases in the disease-free survival (DFS) rate and the total survival rate at the 3rd year and 5th year (all P < 0.05) , and a notable reduction in ER-α36 expression in breast cancer tissues (P < 0.05). Based on the our results, Xiaoaiping can significantly enhance short-term ad long-term efficacies of neoadjuvant chemotherapy for breast cancer. Its mechanism may be correlated with the inhibition of ER-α 36 expression in breast cancer tissues.
Adult ; Aged ; Antineoplastic Agents ; administration & dosage ; Breast Neoplasms ; drug therapy ; genetics ; metabolism ; mortality ; Combined Modality Therapy ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; administration & dosage ; Estrogen Receptor alpha ; genetics ; metabolism ; Female ; Humans ; Middle Aged ; Neoadjuvant Therapy ; Treatment Outcome

Objective To investigate the association of serum levels of soluble intercellular cell adhesion molecule-1 (sICAM-1),soluble vascular cell adhesion molecule-1 (sVCAM-1) and high sensitivity C-reactive protein (hs-CRP) with peripheral vascular disease of lower limbs in patients with type 2 diabetes mellitus (T2DM).Methods One hundred and thirty T2DM patients admitted from October 2011 to October 2012,and 30 age/sex-matched healthy subjects were enrolled in the study.The serum levels of sICAM-1,sVCAM-1,hs-CRP and other clinical parameters were measured; the peripheral blood vessels of lower limbs were examined with color Doppler ultrasonography.Based on the extent of angiopathy of lower limbs T2DM patients were classified as normal vascular group (n =26),mild angiopathy group (n =45),moderate/severe angiopathy group (n =59).Results The serum levels of sICAM-1 and sVCAM-1 in moderate/ severe angiopathy group of T2DM patients were higher than those in mild angiopathy group,normal vascular group and healthy controls (t:4.15-8.93,all P ＜0.05) ; the serum levels of hs-CRP in moderate/severe angiopathy group were higher than those in mild angiopathy group,normal vascular group and healthy controls (t:2.18-4.27,all P ＜ 0.05).The serum sICAM-1 level was positively correlated with total cholesterol (TC),low density lipoprotein cholesterol (LDL-C) and sVCAM-1.The serum sVCAM-1 level was positively correlated with course of disease,systolic blood pressure and CRP.Conclusions Serum levels of sICAM-1,sVCAM-1 and hs-CRP are correlated with the extent of angiopathy of lower limbs in T2DM patients,and the elevated sICAM-1 ; sVCAM-1 and hs-CRP levels are also associated with hyper blood pressure,dislipidemia and chronic inflammation.

Objective To investigate the prevalence of overweight,obesity and related metabolic diseases among male public institution office workers in health check-up.Methods Total 1 018 male public institution office workers aged 23-60 underwent annual health check-up at our hospital in 2012.The data including blood pressure,waist circumference,height,body weight,serum glucose,plasma lipids and serum uric acid were analyzed.According to body mass index (BMI),the subjects were classified as:underweight(BMI ＜ 18.5 kg/m2),normal weight (18.5 kg/m2 ≤ BMI ＜ 24 kg/m2),overweight (24 kg/m2 ≤ BMI ＜ 28 kg/m2) and obesity(BMI≥28 kg/m2).Results The prevalence of overweight,obesity,central obesity and metabolic syndrome (MS) were 40.9％ (416/1 018),7.9％ (80/1 018),53.0％ (540/1 018),and 11.2％ (114/1 018),respectively.There were significant differences in fasting blood glucose (FPG),TC,TG,uric acid(UA),systolic blood pressure(SBP) and diastolic blood pressure(DBP) levels among different groups (F =4.82,12.09,40.55,6.19,28.97 and 49.29,respectively,all P ＜0.01).The prevalence rate of hypertension in underweight,normal,overweight and obesity groups was 0,11.8％,27.4％ and 37.5％,respectively; that of diabetes was 0,1.6％,5.5％ and 10.0％,respectively; that of hyperlipidemia was 40.0％,47.2％,66.3％ and 71.2％,respectively; that of hyperuricemia was 0,5.0％,13.5％ and 13.8％,respectively,which showed that with the increasing of BMI,the prevalence rates of related metabolic diseases were increased(x2 =55.97,9.65,43.32 and 24.08,all P ＜0.01).And the co-morbidity rate with ≥3 diseases in 4 BMI groups were 0(0/20),1.4％ (7/502),5.8％ (24/416) and 13.8％ (11/80),respectively (x2 =31.90,P ＜ 0.01).Conclusion Obesity and overweight are correlated with metabolic disorders and the obese subjects are at high risk for cardiovascular diseases.

Objective To investigate the association of serum visfatin and free fatty acid (FFA) with insulin resistance in type 2 diabetes mellitus (T2DM).Methods One hundred and nineteen patients with T2DM and 65 health subjects with normal glucose tolerance (NGT) were enrolled in the study.TheT2DM patients were further classified as insulin resistant (HOMA-IR ＞ 2.8 mU/L,T2DM-IR group,n =61) and non-insulin resistant (HOMA-IR≤2.8 mU/L,T2DM-NIR group,n =58).Serum visfatin,free fatty acid and related clinical variables were measured,and HOMA-IR was calculated.Results The serum levels of visfatin and FFA in T2DM patients were significantly higher than those in healthy controls [(4.7 ±2.5) vs.(1.7±0.9) ng/L,t=-11.831,P＜0.01; (1.65±0.69) vs.(0.61 ±0.21) mmol/L,t=-9.239,P ＜0.01].The serum levels of visfatin and FFA in T2DM-IR group were significantly higher than those in T2DM-NIR group [(6.3±2.3) vs.(3.0±1.4) ng/L,P＜0.01; (2.16±0.45) vs.(1.12± 0.46) mmol/L,P ＜0.01].Multiple regression analysis showed that FFA,fasting insulin level and waist/ hip ratio (WHR) were independent risk factors of serum visfatin level (r =0.564,0.267 and 0.188 respectively,all P ＜ 0.05).Conclusion Serum levels of visfatin and FFA are increased in T2DM,and they are closely associated with insulin resistance.

Objective To investigate abdominal visceral fat area and its relationship with insulin resistance in male patients with type 2 diabetes and normal body mass index (BMI).Methods Seven male patients with type 2 diabetes and normal BMI were divided into two groups according to the abdominal visceral fat area (VFA) measured by CT:visceral obesity group (VFA ≥ 100 cm2) and non-visceral obesity group.Indicators of glucose and lipids metabolism were measured in two groups.Results Among 70 patients 50 (71％) had visceral obesity.In 59 patients who had normal BMI and normal waist circumference (≤90 cm),41 presented visceral obesity (69％).Compared with non-visceral obesity group,the waist circumference,homeostasis model assessment of insulin resistance (HOMA-IR),triglyceride,and VFA were significantly higher in visceral obesity group [(86.4 ± 5.6) vs.(81.2 ± 4.8) cm,t =-2.980,P ＜ 0.01;2.83±2.31 vs.2.01±1.30,t=-2.025,P＜0.05;1.93(1.26-2.79) vs.1.11(0.75-1.46) mmol/L,Z=-3.777,P＜0.01;(143.6 ±31.8)vs.(73.7 ±17.3)cm2,t =-11.456,P＜0.01].Fasting insulin,fasting plasma glucose and glycosylated hemoglobin tended higher in visceral obesity group but not significantly (P ＞ 0.05).Multiple linear regression analysis showed that after adjustment for age and body mass index,abdominal VFA was positively correlated with HOMA-IR (r =0.240,P ＜ 0.05).Conclusion Male type 2 diabetic patients have a high rate of visceral obesity even when their body mass index and waist circumference are normal.Abdominal visceral fat area is closely associated with insulin resistance.

OBJECTIVE:To observe the efficacy and safety of metformin in the treatment of type 2 diabetes(T2DM) with non-alcoholic fatty liver disease(NAFLD). METHODS:106 patients with T2DM with NAFLD were randomly divided into control group and observation group. Control group was received health education about T2DM with NAFLD and living intervention(diabe-tes diet and physical therapy);observation group was additionally given Metformin tablet 0.5 g,orally,3 times a day. The treat-ment course for both groups was 12 weeks. Clinical efficacy,and liver fat content,BMI,FPG,IR,TG,TC,LDL-C,HDL-C,HbA1c before and after treatment,and incidence of adverse reactions in 2 groups were observed. RESULTS:After treatment,liver fat con-tent and related index in 2 groups were significantly better than before(except HOMA-IR in control group),and observaton group was better than control group,the differences were statistically significant(P<0.05). The total effective rate in observation group was significantly higher than control group,the difference was statistically significant(P<0.05). CONCLUSIONS:Based on the conventional treatment,metformin has good efficacy and safety in the treatment of T2DM with NAFLD.

Objective We conducted a systematic review and meta-analysis of the published literature to evaluate the efficacy of prophylactic antibiotics in the prevention of incisional infection of inguinal tension-free hernioplasty.Methods Articles of randomized controlled trials about the efficacy of prophylactic antibiotics in the prevention of incisional infection in the inguinal tension-free hernioplasty published from January 1975 to October 2012 was retrieved and systematically reviewed.Results A total of 11 randomized controlled trials meeting the inclusion criteria were screened.Among the 4159 cases of patients,130 cases had wound infection,and the infection rate was 3.13％.In the prophylactic antibiotics group of 1845 cases,wound infection occurred in 45 cases; the infection rate was 1.94％.In the control group of 2314 cases,85 cases had incision infection; the infection rate was 3.67％.The preventive use of antimicrobial drugs reduced surgical site infection of inguinal tension-free hernioplasty (OR 0.55,95％ CI 0.38-0.80,P =0.002).Conclusions The use of prophylactic antibiotics can effectively reduce the incisional infection in the inguinal tension-free hernioplasty.