Type 2 diabetes mellitus (T2DM) is a common chronic metabolic disorder,it results from an interaction of environmental as well as genetic factors.There were several kinds of oral antidiabetic drugs (OADs),including biguanides,sulfonylureas,thiazolidinediones,and meglitinides,etc.Several genes have been identified to be associated with disease development and therapeutic outcomes.Inter-individual variations in the human genome affect both,risk of T2DM development and personalized response to identical drug therapies.Pharmacogenomics approaches focus on single nucleotide polymorphisms and their influence on individual drug response,efficacy and toxicity.Therefore,pharmacogenomics in T2DM is of great importance towards precision medicine which will greatly improve the efficacy of diabetes treatment.In this paper,antidiabetic drugs and related gene polymorphism researches are reviewed.

Rheumatoid arthritis(RA),a systemic,inflammatory autoimmune disorder characterized by inflammation of the lining or synovium of the joints,is a complex polygenic disease with a complicated inheritance mode.Both genetic and environmental factors determine the development and progression of RA.Study on susceptible genes of RA provides a theoretic basis for clinical diagnosis and treatment.As a novel high-throughput screening method,genome-wide association study(GWAS) is a powerful approach for mapping susceptible genes of polygenic disease like RA.GWAS can not only verify the well-established susceptible loci,but also identify novel genetic loci candidates.Great improvement has been made in using GWAS to screen for novel genes,which casts new lights on the mechanism and treatment of RA.This review summarizes the progress in using GWAS for screening of RA susceptible genes.

Objective To understand the practice of experiential teaching in the core midwifery curriculum. Methods Phenomenology as a qualitative research method was utilized and fifteen students participated in the non-structured interviews. Results Four themes were found: comprehension of knowledge;professional thought; teacher- student relationship;gratitude. Conclusions Experiential teaching can increase the teaching effect of core midwifery curriculum, and develop good ideological and professional qualities.

Objective: To investigate HDAC5 expression in gastric cancer cell lines and its effects on the proliferation and apoptosis of the gastric cancer line SGC-7901. Methods: The expression patterns of HDAC5 and Twist1 in gastric cancer cell lines and normal gastric mucosal cells were detected by Western blot. The effects of HDAC5 and Twist1 on the proliferation and apoptosis of SGC-7901 cells were analyzed by MTT and flow cytometry, respectively. Results: The expression of HDAC5 and Twist1 in gastric cancer cell lines were significantly higher than that in normal gastric mucosal cells (P<0.05). HDAC5 knockdown significantly down-regulated Twist1 expression,inhibited cell proliferation, and induced apoptosis in SGC-7901 cells, whereas HDAC5 overexpression exhibited an opposite effect (P<0.05). Moreover, Twist1 knockdown significantly inhibited cell proliferation and induced apoptosis in SGC-7901 cells (P<0.05). Conclusion:HDAC5 may promote cell proliferation and inhibit apoptosis in gastric cancer cells by upregulating Twist1 expression, thus promoting the initiation and development of gastric cancer.

Objective:To investigate the molecular mechanism of PDGFC regulated by HuR in breast cancer cells.Methods:Through the software analysises,we first predicted the HuR-binding sites on the PDGFC 3'-UTR in breast cancer cells;An RNA-immunoprecipitation tested the interaction of HuR with the PDGFC mRN after adding PDGFC stimulation;Luciferase experiments tested the HuR-binding sites of PDGFC regulated by HuR through structuring five truncated of PDGFC 3'UTR.Results:We found five HuR-binding sites in the 3'UTR of PDGFC by software prediction;The RNA-immunoprecipitation showed the co-immunoprecipitation of HuR and PDGFC mRN after adding PDGFC stimulation confirming the direct association of HuR with the PDGFC;Luciferase experiments ofPDGFC mRNA 3'UTR showed that PDGFC regulated by the second and fourth HuR-binding sites.Conclusions:This study reveals the molecular mechanism of PDGFC regulated by HuR through binding to PDGFC mRNA 3'UTR in breast cancer cells,and provided rationale for the development of strategies in the clinical diagnosis and treatment for breast cancer.

r diagnosing the disease to combine pathology, immunohistochemistry and SYT-SSX gene detection.

ObjectiveTo evaluate CT and MRI findings of the intrathoracic ganglioneuroma and to improve its diagnosis and differential diagnosis ability.MethodsClinical,CT( n = 14),MRI (n = 6) and pathology manifestations of 20 patients with the intrathoracic ganglioneuroma were retrospectively analyzed.All 20 cases had chest CT and MRI plain scanning and multiphase enhance scanning before operation.ResultsSeventeen of 20 lesions were located in posterior mediastinum,2 in pleura side and 1 in right thorax cavity.The CT value of the plain scans ranged from 20 to 40 HU ( mean 30.5 HU),Tubercle calcification were detected in four masses,one case with fat density was showed on CT scanning.After injecting contrast media,CT value ranged from 0 to 12 HU (mean 6.2 HU) in artery phase,ranging from 10 to 20 HU ( mean 14.3 HU) in delay phase.Five of 6 cases of MRI signals were homogeneously low intensity on T1 WI,1 case with fat signal was imhomogeneously low intensity on T1WI.Six cases were imhomogeneously high intensity on T2WI.A whorled appearance was visualized in one tumor on T2WI.The post-contrast enhancement MR images was slight enhancement imhomogeneously in artery phase and gradual increasing enhancement in delay phase.ConclusionOn CT and MR imaging,no enhancement or slight enhancement in artery phase and gradual increasing enhancement in delay phase are characteristic manifestations of ganglioneuroma in the thorax.

Purpose To explore the CT manifestations and pathological features of pneumonia-type lung cancer, and to improve the diagnosis capability of pneumonia-type lung cancer. Materials and Methods CT and pathologic features of 33 cases of biopsy or surgical pathology confirmed pneumonia-type lung cancer patients were retrospectively analyzed and classified according to the new pulmonary adenocarcinoma classification. Results Among the 33 pneumonia-type lung cancer subjects, CT showed multiple distributions within both lungs in 22 cases, lateral lobe distribution in 9 cases, segmental distribution in 2 cases. Lung consolidation was found in all lesions, among them 21 cases appeared mainly as lower lobe consolidation, 32 cases as inflatable bronchial symptoms within the consolidation, including inflatable bronchoconstriction in 24 cases;consolidation with multiple pulmonary nodules found in 23 cases;ground glass shadowing around or distal to the consolidation found in 26 cases;combined with cysts or honeycomb lung symptom in 13 cases. Inhomogeneous mild enhancement of lung consolidation after enhancement found in 18 cases and inhomogeneous moderate enhancement in 15 cases;blood vessel branch shadow within the consolidation was visible in 21 cases. Pathology results revealed 26 cases of invasive mucinous adenocarcinoma, and 7 cases of invasive mucinous adenocarcinoma partial mixed with papillary or alveolar adenocarcinoma. Conclusion CT features of pneumonia-type lung cancer are single or multiple opacities, within which inflatable bronchial symptoms can be observed, with multiple nodules and ground glass shadowing, cysts or honeycomb symptom can also be found concomitant, the lesions expand, increase and spread to both lungs, taking its dynamic change features into consideration will also help to improve the diagnostic accuracy.

ObjectiveTo evaluate the clinical feasibility of low dose MSCT for quantitative assessment of pulmonary function in smokers.MethodsOne hundred and forty-six patients with chronic objective pulmonary disease ( COPD ) including 109 smokers ( 74.6％ ) and 37 non-smokers ( 25.3％ )underwent pulmonary function test and low-dose MSCT scan.All data were analyzed using computer-aided lung anlysis software.Pulmonary function parameters from low-dose MSCT were compared between smokers and non-smokers and also compared with pulmonary function test in non-smokers ( Pearson test).Results In smokers,the average volume at full inspiratory phase (Vin) was (5125 ± 862 ) ml,mean lung attenuation was ( - 902 ± 26 ) HU,mean lung density was (0.0984 ± 0.0260 ) g/cm3,emphysema volume was (2890 ±1370) ml.The average volume at full expiratory phase (Vex) was (2756 ±1027) ml,mean lung attenuation was ( -811 ±62) HU,mean lung density was (0.1878 ±0.0631 ) g/cm3,emphysema volume was (685 ±104) ml.In non-smokers,the average Vin was (3734 ± 759) ml,mean lung attenuation was ( -876 ±40) HU,mean lung density was (0.1244 ±0.0401 )g/cm3,emphysema volume was ( 1503 ± 1217) ml.The average Vex was ( 1770 ± 679 ) ml,mean lung attenuation was ( - 765 ± 56 ) HU,mean lung density was (0.2360 ± 0.0563 ) g/cm3,emphysema volume was ( 156 ± 45 ) ml.There were significant differences between smokers and non-smokers (P ＜0.01 ).The Vex/Vin was correlated with residual volume/total lung capacity ( RV/TLC,r =0.60,P＜0.01 ),and Vin was correlated with TLC ( r =0.58,P ＜ 0.01 ),Vex with RV ( r =0.59,P＜0.01 ).Pixel index ( PI ) -950in was correlated with FEV 1％ pre and FEV1/FVC％ ( r =- 0.53,- 0.62,respective,P ＜ 0.01 ),Pl-950ex was correlated with FEV1 ％ pre and FEV1/FVC％ ( r =-0.71,-0.77,respective,P＜0.0l).ConclusionLow-dose MSCT can be a potential imaging tool for quantitative pulmonary function assessment in smokes.

Objective: To evaluate chemiluminescence immunoassay (CLIA) for detecting blood levels of aldosterone and rennin with its diagnostic value of primary aldosteronism (PA) with comparison to radio immunoassay (RIA). Methods: According to American protocols of CLSI, we conducted a veriifcation study between RIA and CLIA for their precision, accuracy, linearity and reference ranges; meanwhile, taking clinical diagnosis as golden standard, examined renin activity or concentration and aldosterone concentration in 20 healthy volunteers and 40 hypertension patients by both RIA and CLIA, compared the ratios of ARR (aldosterone concentration/renin activity) or ADRR (aldosterone concentration/renin concentration) for the speciifcity and sensitivity of PA diagnosis. Results: Within-lot and between-lot accuracies of CLIA for detecting aldosterone levels were below 5% and 10%, the recoveries were 102% and 95% respectively. There was a good linear correlation in the range of aldosterone at (3-74) ng/dl and renin at (0.99-330) μIU/ml. In healthy volunteers, renin level was higher in 2 subjects, while aldosterone level and ADRR ratio were within normal references in all subjects by the manufacturer. In hypertension patients, the sensitivity and speciifcity for aldosterone and rennin detections by CLIA were at 85.7% and 97.0%, by RIA were at 85.7% and 94.0%. Conclusion: CLIA has the superiority of simple performance, repeatable and without radioactive contamination; it is recommended for replacing RIA as necessity.