Type 2 Diabetes is the consequence of the disturbances of both α- and β-cell secretions.Glucagon-like peptide-1 ( GLP-1 ),which regulates the function of alpha and beta cells,has led to the emergence of a new class of oral anti-diabetic drugs.DPP-4 inhibitors,which increase the concentration of GLP-1 and consequently improve HbAlC,have become a choice for patients in different stages of diabetes.

Antiviral Agents ; administration & dosage ; therapeutic use ; Hepatitis C ; drug therapy ; Humans ; Liver Cirrhosis ; drug therapy

Objective To investigate the feasibility of segmental splenectomy for treatment of splenic benign tumor. Methods The clinical data of 6 patients with splenic benign tumor treated in our hospital with spleen-preserving surgery in the past 2 years were retrospectively analyzed. Results All the 6 patients successfully underwent surgery and recovered smoothly after operation. No acute severe infection occurred. Ultrasonography showed that the blood supply of residual spleen was of no problem. The components of peripheral blood had no significant changes after operation. Conclusion As long as we know the vascular anatomy of spleen well, segmental splenectomy is safe, reliable and feasible.

Objective To observe the effect of liraglutide on arteriosclerotic lesions in diabetic ApoE- / - mice via regulating receptor for advanced glycation end-products ( RAGE) expression of aorta. Methods Thirty male ApoE- / - mice (10 weeks) were randomly divided into 3 groups: control group, diabetes group, and diabetes +liraglutide group. All the mice were fed a high-fat diet. Diabetes was induced by 2 intraperitoneal injection of streptozotocin (STZ, 55 mg·kg-1 ·d-1 ). Mice were treated with subcutaneous injection of liraglutide (0. 4 mg· kg-1 ·d-1 ) in diabetes+liraglutide group. After 9 weeks, blood was drawn and the aorta were rapidly procured. The serum levels of advanced glycation end-products ( AGEs), soluble receptor for advanced glycation end-products (sRAGE ), stromal cell-derived factor-1α ( SDF-1α ), as well as total cholesterol and triacylglycerol were measured. Atherosclerotic plaque area was determined by Sudan Ⅳ staining. The expression of RAGE was determined using RT-PCR and western blot, respectively. Results Compared with control group, the serum AGEs, the RAGE protein and mRNA expression, the atherosclerotic lesions were significantly increased in the mice of diabetes group. Compared with diabetes group, the serum AGEs, the RAGE protein and mRNA expression, the atherosclerotic lesions were significantly decreased in the mice of diabetes+liraglutide group. Conclusion Liraglutide is confirmed as to have an anti-atherosclerotic effects and inhibits RAGE expression in diabetic ApoE- / - mice.

Objective　To examine the intraindividual reproducibility of the octanoic acid breath test in normal subjects and diabetics and to investigate whether cardiovascular autonomic neuropathy and delayed gastric emptying influence the intraindividual reproducibility.Methods　Nine normal subjects (six men, three women,mean age 38 years) and 15 diabetics with insulin treatment ［nine men, six women; mean age 47 years; six had cardiovascular autonomic diabetic neuropathy (CADN) and/or delayed gastric emptying time］ were, after a nocturnal fasting period, given a standard test meal (labeled with 13C-octanoic acid, 1 046 kJ). Breath samples were taken at ten minute intervals over first one hour and at fifteen minute intervals over the following three hours and examined for 13CO2 by isotope ratio infrared spectrometry. Using a regression method gastric emptying half times (t1/2) and lag phase (tlag) were determined.Results　There was not a significant difference of t1/2 and tlag between two measurements in normal subjects and diabetics. The coefficients of variation of day-to-day reproducibility were 11.7% for t1/2, 19.4% for tlag in normal subjects and 17.8% for t1/2, 28.2% for tlag in diabetics, but there was not significant difference between normal subjects and diabetics. There was not significant difference of intraindividual coefficient of variation of t1/2 and tlag between diabetics with/without CADN and between diabetics with normal gastric emptying time and diabetics with delayed gastric emptying time.Conclusions　 The 13C-octanoic acid breath test has a high intraindividual reproducibility which is not affected by the cardiovascular autonomic neuropathy and delayed gastric emptying. It can be recommended as a non-invasive test for assessing gastric emptying time after a solid test meal in diabetics.

Objective To examine the relationships among measures of gait recovery and community integra-tion index in people with brain injury.Methods 142 brain injured patients were chosen in this study.Community Balance and Mobility Scale,Dynamic Gait Index,Ten-Meter Walk Test for gait speed,and the Community Integration Questionnaire (CIQ) was measured.Results Average walk speed was 0.31-5.30 (1.36 ±0.88)m/s;DGI score was 5-24 (18.6 ±5.44) points;CMBS score was 0 -96 (54.1 ±25.3) points;CIQ subscale 6 -29 (16.2 ± 5.1)points,CIQ family subscale was 0-10 (4.8 ±3.0)points;CIQ society subscale was 4-12(8.2 ±2.1)points;CIQ productivity subscale was 0-7(3.8 ±2.2).The correlation between age and Ten-Meter Walk Test was nega-tive significantly (r=-0.50,P<0.05).All 3 balance/gait measures correlated significantly with the CIQ Productiv-ity subscale (r=0.35-0.58,P<0.05).Conclusion The ability of people with brain injury to engage in work/school/volunteer activity may be reduced by impairments in balance and mobility.

Objective:To investigate the inhibitory effect of 4'-methylether-scutellarein(4-MS),an extract from Verbena officinalis,on human choriocarcinoma JAR cell line and the possible mechanism.Methods:JAR cells were exposed to 4'-methylether-scutellarein of different concentrations for 48 h.MTT assay was used to examine the anti-proliferative effect of 4'-methylether-scutellarein.Flow cytometry was used to investigate the apoptosis and the changes of cell cycle.AO/EB double staining was applied to discriminate the apoptotic cells from dead ones.The changes of Survivin,p38-MAPK and Caspase 3 mRNA expressions were detected by RT-PCR in JAR cells treated with 4-MS.Furthermore,Western blotting assay was used to determine Survivin protein expression,phosphorylation level of p38 and Caspase 3 in JAR cells before and after 4-MS treatment.Results:4-MS inhibited the proliferation of JAR cells in a dose- and time-dependent manner(P

Objective To evaluate the clinical characteristics,pathology,treatment and prognosis of gastrointestinal stromal tumors.Methods A retrospective analysis was made on clinical data of 469 patients with gastrointestinal stromal tumors (GIST) admitted between January 2010 and August 2016.Results There were 231 males and 238 females,the median age was 57 years old.The tumor was located in the esophagus in 6 cases (1.3％),in the stomach in 295 cases (62.9％),in the duodenum in 23 cases (4.9％),in the small intestine in 69 cases(14.7％),in the colorectum in 26 cases (5.5％).There were altogether 50 cases (10.6％) in this group with a final diagnosis of extra-gastrointestinal stromal tumors.Tumor invasion depth,risk of ulcer caused bleeding and NIH classification varied with its locations (all P ＜ 0.05).Conclusions The clinical characteristics of gastrointestinal stromal tumors can be used to preliminarily predict its malignant degree.Surgical resection is the treatment of choice,and postoperative recurrence or metastases of gastrointestinal stromal tumors can be treated by imatinib.

Objective To explore the effects of the continuous quality improvement ( CQI) on recovery and health of patients with chronic kidney disease ( CKD) .Methods The clinical data of 485 cases with CKD undergoing standard treatment from Jan .30th, 2012 to Dec.30th, 2012 in Shaoxing People's Hospital were retro-spectively analyzed .A professional team introduced four-step intervention of continuous quality change .The nu-tritional status, renal function changes , and patients'cognition and compliance with low protein diet before and af-ter treatment were compared .Results The nutritional status of patients significantly improved after the treat-ment.The patients with score ≥23 points increased 58.14%.After CQI intervention , urinary albumin/creati-nine (mg/g) was calculated and it was 82.17 before treatment and 64.23 after treatment.The difference had sta-tistical significance (t=11.321,P＜0.05).After the treatment, 82.06% patients understood low-protein diet concept .The treatment was implemented well and the overall data improved significantly .Conclusions CQI has beneficial effects on immunity and renal function recovery of patients with CKD .It can significantly improve the patients'nutritional status , and their cognition of low protein diet .

Diabetes is common in men and women aged 50 years and older often complicated with peripheral arterial disease(PAD) arousing more serious attention by vascular surgeon and interventional radiologist. The present review of this article put the main focus on curative effect and limitation of intravascular treatment for patients with diabetic PAD, including proper medical imagings for suitable follow-up and formation of regular managing program for accessing limb function and whole body condition. Furthermore the dosage and proceduce of medical thrombolysis in dealing diabetic PVD, together with the possibility of mechanical thrombolysis approach should expecially emphasized. For further objective acknowledgement of interventional therapy for diabetic PVD; the selection of interventional procedune, the management of single or mutliple lesions and post procedural treatment ought to be considered thoroughly before hard.