Objective To investigate the clinical efficacy and safety of sitagliptin combined with metformin in treating patients with type 2 diabetes with non-alcoholic fatty liver diease (NAFLD).Methods Sixty-five patients with type 2 diabetes with non-alcoholic fatty liver admitted into our hospital from June 2012 to June 2015 were randomly divided into two groups.Thirty-three patients in control group were treated with metformin only,and thirty-two patients in observation were treated with sitagliptin combined with metformin.The changes in body mass index (BMI),fasting plasma glucose (FPG),2-hour postprandial glucose (2hPG),Hemoglobin Ale (HbAlc),homeostasis model assessment of insulin resistance (HOMA-IR),and liver function index including that aminopherase of alanine acid (ALT),aminopherase of aspartic acid (AST),gamma-glutamyl transterase (GGT),triglyceride (TG),and total cholesterol (TC) were detected before and after 16 weeks of treatment.And the total effective rate and safety were analyzed and compared.Results After treatment,HOMA-IR,FPG,2hPG,HbA1c,ALT,AST,GGT,TG,and TC were remarkable improvement (P ＜ 0.05),and HOMA-IR,HbA1c,AST,ALT,GGT,and TG were significantly better than those of control (P ＜ 0.05).Additionally,the total effective rate in observation group with 90.9％ was significantly higher than that of control group with 42.4％ (P ＜ 0.05).And difference in incidences of adverse effect between observation group with 15.6％ and control group with 9.1％ were not significant.Conclusion Sitagliptin combined with metformin treatment had a good ability on treating patients with type 2 diabetes with NAFLD by improvement of metabolic syndrome and liver function.

Objective To evaluate the clinical safety and efficacy of Cheatham-Platinum(CP)covered stent in treatment of aortic coarctation.Methods The therapeutic efficacy was retrospectively analyzed in 15 patients with aortic coarctation who were treated by BIB balloon dilation and CP covered stent implantation.Results All patients were well recovered,the stent did not appear displaced,folded,aorta dissection and rupture.The pressure difference was 5-10 mm Hg(1 mm Hg=0.133 kPa)between proximal part and distal end after operation.Following up(20±12)months,the therapy efficacy of all the patients was stable and there was no fracture,removal,aortic stenosis or dysarteriotony.Heart ultrasounds demonstrated good close of the cases with patent ductus arteriosus.Conclusion CP covered stent is a safe and available clinical therapy,featured by minimum aorta injuries.

Child ; Humans ; Laryngeal Diseases ; pathology ; therapy ; Vocal Cords ; pathology

Objective To investigate the expression of Smad5 gene in the cochlea and to identify its location. Methods Reverse transcription polymerase chain reaction (RT-PCR) was employed to detect the expression of Smad5, the in situ hybridization and the immunohistochemical technique were used to localize the Smad5 messenger RNA and the Smad5 protein in mouse cochlea. Results Smad5 gene expressed in cochlea at a high level. Smad5 expression was concentrated in supporting cell, hair cell, spiral ganglion, epithelium of stria vascularis and basilar membrane. Conclusion The Smad5 proteins exist in the mouse cochlea and it may be involved in the cochlear formation and the differentiation of hair cell. Smad5 might be an essential factor for the development of normal cochlea.

Objective To investigate the possible role of leukocytes, a important cellular component of the blood, in the induction of microcirculatory disturbances in noise-exposed cochleae. Methods Guinea pigs were exposed to a 4 kHz narrow band noise at 115 dB SPL for 4 hours, and the exposed cochleae were collected at 2 or 4 days after the noise exposure. Several techniques (cell viability assay, fluorescent labeling for blood plasma and for hair cell nuclei) were used to examine morphological changes in microvessels in the spiral lamina and in the stria vascularis as well as the hair cell nuclei. Results In noise-exposed cochleae, aggregatad leukocytes were found in the vessels of the spiral lamina. In the up-stream of the vessels with aggregated leukocytes, red blood cells were tightly packed, causing an increase in vessel diameters. Most leukocytes were located within the lumen of vessels, but some of them infiltrated the spiral lamina, usually alongside the vessels. Cell viability, assessed by trypan blue staining, showed that these plugged leukocytes lost their viability. In contrast, no leukocytes aggregated in the vessels of the stria vascularis, nor did leukocytes lose their viability. Conclusion In the cochleae exposed to intense noise, leukocytes were trapped in the vessels of the spiral lamina, leading to disturbance of blood flow. The involvement of leukocytes in local damaging processes and the fate of leukocytes need further studies.

To observe the morphological changes in hair cell nuclei in guinea pigs following noise exposure, guinea pigs were exposed to 4 kHz narrow band noise at 115 dB SPL for 4h. The cochleae were collected for the examination of the hair cell nuclei 14 days after the noise exposure. A fluorescent dye, Hoechst 33342,a fluorescent dye, was used to label the nuclear DNA and the specimens were examined under a fluorescence microscope for quantitative assessment of hair cell nuclear damage. There were three types of morphological changes in the damaged hair cell nuclei: nuclear swelling, nuclear condensation (karyopyknosis) and nuclear missing. Nuclear swelling was more frequent than nuclear missing. Nuclear condensation was less frequently found. The results suggested that complicated, long term and non synchronous biological processes might be involved in noise induced hair cell damage. A large number of hair cells with swollen nuclei, which might recover afte wards,still could be seen in the cochlea two weeks after noice exposure.

Adolescent ; Adult ; Boron ; adverse effects ; Humans ; Male ; Occupational Exposure ; Sperm Count ; Sperm Motility ; drug effects ; Spermatozoa ; drug effects

Objective To explore the clinical value of transvaginal three-dimensional color Doppler ultrasound in assessing effects of Chinese herbal drugs on improving endometrial receptivity in patients with thin endometrium.Methods A total of 76 cases of patients diagnosed with thin endometrium in Jiangbei District Hospital of Traditional Chinese Medicine from June 2015 to October 2016 were selected and treated with Chinese herbal prescription for three months.The endometrial thickness,endometrial volume and blood flow indexes before and after treatment were measured by using transvaginal three-dimensional color Doppler ultrasound.Results After 3 months treatment,the endometrial thickness and endometrial volume were increased,and the pulse index (PI) and resistance index (RI) of endometrial blood flow were decreased,compared with those before treatment,there were statistically significant differences(P＜0.05).The results of three-dimensional color Doppler ultrasound indicates that after 3 months treatment the vascularization index (VI),flow index (FI) and vascularization flow index (VFI) were significantly higher than those before treatment,there were statistically significant differences (P＜0.05).Conclusion The Chinese herbal prescription could increase the thickness and volume of endometrium,augment blood supply,and improve endometrial receptivity significantly.Transvaginal color three-dimensional Doppler ultrasound is a convenient and objective method for evaluating clinical efficacy of Chinese herbal prescription in patients with thin endometrium,which has high practical value.

Objective To investigate the methods of X-ray diagnosis of various displacement of unstable pelvic fracture in three-dimensional space and its instructive significance in closed reduction.Methods A normal adult pelvic specimen was selected and fixed in a wood-frame at supine position after soft tissue rejection and ligament preservation.With the breakage at the unilateral anterior-posterior ring,models of hemipelvic rotation in the transverse and sagittal planes and hemipelvic vertically upward displacement were induced.Anteroposterior radiographs of the pelvic specimen were made and picture archiving and communication system (PACS) was used to measure width of iliac wing,suprainferior diameter of hemipelvis,vertical displacement of iliac crest,acetabulum roof,pubic tubercle and sciatic tuber and area of obturator foramen.Methods of X-ray diagnosis of various displacements of hemipelvis were concluded and applied in treatment of 43 patients with unstable pelvic fractures.Operation time and intraoperative blood loss were recorded.Postoperative images were evaluated by Matta standard.Results Hemipelvic rotation in transverse plane included eversion and inversion.Width of iliac crest was enlarged and area of obturator foramen was shrunk while extroversion ; on the contrary,an opposite result was observed while inversion.Sagittal rotation included pronation and supination.Pubic tubercle had obvious downward shift,iliac crest presented no change or slight upward shift,suprainferior diameter of hemipelvis was lengthened,iliac roof and sciatic tuber remained their position unchanged and area of obturator foramen was shrunk while pronation; on the contrary,pubic tubercle had obvious upward shift,iliac crest presented no change or slight downward shift,suprainferior diameter of hemipelvis was shortened,iliac roof and sciatic tuber remained their position unchanged and area of obturator foramen was enlarged while supination; iliac crest,acetabular roof,pubic tubercle and sciatic tuber presented equidistant upward shift while the hemipelvis displaced upward vertically.Average operation time was 55 minutes (range,15-85 minutes) and intraoperative blood loss was 26 ml (range,10-50 ml).According to Matta standard,pelvic radiography evaluation at postoperative 3 days was excellent in 31 cases and good in 12 cases,with excellent and good rate of 100％.Conclusion Pelvis X-ray films are able to diagnose various three-dimensional displacement of unstable pelvic fractures and guide closed reduction timely and rapidly to achieve satisfactory result.

ObjectiveTo study the technique and therapeutic effect of percutaneous cannulate screw fixation to treat the traumatic diastasis of the pubic symphysis.MethodsFrom February 2003 to December 2010,46 patients (27 men and 19 women,mean age of 34.6 years) with unstable pelvic fractures and diastasis of the pubic symphysis were admitted.All the patients were treated by closed reduction and percutaneous cannulate screw fixation of the symphysis pubis.Then to complete the fixation of posterior ring,by percutaneous screw inserted through the sacroiliac joint or posterior iliac wing.According to Tile's classification,the patients were classified into type B1.1 in 4 cases,B1.2 in 7,B2 in 2,B3 in 2,C1.1 in 7,C1.2 in 7,C1.3 in 10,C2 in 5 and C3 in 2.All patients were performed posterior ring fixation except 4 cases of type B1.1.Anteroposterior,inlet and outlet X-ray radiographs and CT scans of the pelvis were taken preoperatively to evaluate the stability and deformities,and after surgery the plain radiographs and CT scans were taken to evaluate the reduction and the location of screws.ResultsThe average operative time was 45 min (range,15-65 min),and the average intraoperative blood loss was 25 ml (range,15-50 ml).Each patient was inserted one screw in the symphysis pubis.Thirty-five patients underwent postoperative pelvic CT scan and 3screws of them penetrated the wall of symphysis pubis.The average follow-up period was 23.5 months (range,5-48 months).In the follow-up period,no infection and displacement were found.The last follow-up result:according to Matta and Tornetta's standard,the result was excellent in 43 cases and good in 3.Among all patients,31 cases (67.39％) had returned to their original works,6 were to give up their original works as complicating injuries; 28 cases had no pain,13 cases had slight pain of the symphysis pubis while to make an effort,5 cases had pain of sacroiliac joint.There were no iatrogenic injury of nerve.ConclusionClosed reduction and percutaneous cannulate screw fixation of the traumatic diastasis of the pubic symphysis is a safe,feasible and easy manipulated method.The operative injuries is small and the clinical outcome is satisfactory.