Exendin-4,a peptide analogue of glucagon-like peptide-1(GLP-1),is presently in clinical trials as a therapy for type 2 diabetes mellitus.Exendin-4 selectively acts on GLP-1 receptors,which are coupled to the cAMP nucleotide second messenger pathway to enhance the survival and plasticity of neurons in the brain.Exendin-4 has potent effects on homeostasis of Ca2+,on multiple targets to block apoptotic signaling pathways,and on neuronal proliferation and differentiation.It has also been demonstrated to possess properties against oxidative stress and excitotoxicity.In this review the functions of exendin-4 on central nerve system and the potentia therapeutic effects on neurodegenerative diseases will be involved.

Chronic atrophic gastritis (CAG) is the disease with the pathological features of gastric mucosa inherent glands atrophy, mucous membrane thinning, muscularis mucosa thickening, gastric acid secretion decreasing, or along with intestinal metaplasia or pseudopyloric metaplasia. TCM differential treatment has obvious advantages. Through the summary of the literature on CAG, the authors summarize the aspects of etiology and pathogenesis, syndrome differentiation characteristic and their relations with gastroscopic image, pathology, and Helicobacter pylori infection, with a purpose to provide references for TCM clinic.

Metformin is the most commonly prescibed drug for type 2 diabetes mellitus as it is inexpensive, safe, and efficient in ameliorating hyperglycemia and hyperinsulinemia. Numerous epidemiological studies indicate that diabetic population is not only at increased risk of cardiovascular complications, but also at substantially higher risk of many forms of malignancies. Meanwhile, epidemiological and clinical observation studies have shown that metformin use reduces risk of cancer in patients with type 2 diabetes mellitus and improves prognosis and survival rate of the cancer patients. Furthermore, metformin has been used for cancer therapy in clinical trials. Thus, metformin is emerging as a new cancer therapy or adjuvant anticancer drugs. This review summarizes recent progress in studies of metformin use and its molecular mechanism.
Antineoplastic Agents ; therapeutic use ; Diabetes Mellitus, Type 2 ; Humans ; Hyperglycemia ; Metformin ; therapeutic use ; Neoplasms ; drug therapy

Objective To explore the feasibility and value of special carotid cavemous fistula(CCF). Metheds In 28 cases with traumatic history, cerebral angiographies were performed via percutaneous transfemoral route before endovascular embolization. Results Bilateral CCF in 6 cases,unilateral CCFs including mutileakage in 2 cases and small fistulae in 4 cases,CCF combined with fracture segment in 11 cases,traumatic aneurysms in 3 cases,NPPB after embolizationin 2 cases. The fistulas of 9 cases were occluded with patency of internal carotid artery(ICA),and ICA were occluded in 19cases.Conclusions Endovascular embolization of carotid cavernous fistula was safe and effective.This methed should be the first choice for the treatment.Different techniques of endovascular embolization should be undertaken for different CCF.

There are many subjects related to anesthesiology and the band between anesthesiology and clinical practicevery is close. So students can not be proficient in anesthesiology by traditional teaching methods. The use of three-dimensional case teaching method in anaesthesiology teaching is a good attemptment. three-dimensional case teaching method integrate case method, multimedia technology and clinical case. It can help medical students analyze and solve clinical problems, improvetheir academic performance and enhance their clinical basic skills.

AlM: To explore the clinical therapeutic effect of the integrated traditional Chinese and Western medicine treatment of idiopathic panuveitis.
METHODS: Totally 47 patients ( 69 eyes ) with the idiopathic panuveitis were included in this study, which were randomly divided into control group and treatment group. Twenty-four cases (33 eyes) with the method of Western medicine-glucocorticoid and mydriatic were in control group, while 23 cases (36 eyes) with integrated traditional Chinese and Western medicine were in treatment group. Those patients were followed up 12-36mo, the vision before and after treatment, the therapeutic effects, the complications and the side effects of glucocorticoid were recorded.
RESULTS: Both of two groups' vision after treatment were improved, but the vision of treatment group was better than the control group. The effective rate and the cure rate of the treatment group were increased significantly. Of all of the complications, the incidence rate of complicated cataract and secondary glaucoma of the treatment group were reduced significantly. Of all of the side effects of glucocorticoid, the central excitation, hypertension and central obesity of the treatment group were reduced significantly (P<0. 05).
CONCLUSlON: Dialectical therapy of integrated traditional Chinese and Western medicine has better therapeutic effect than simple Western medicine treatment of idiopathic panuveitis, and could better reduce the side effect of glucocorticoid long-term use. lt is worthy applying in clinical practice.

Objective To investigate the localization and surgical outcome of epileptogenic nidus of post-traumatic epilepsy. Methods A retrospective analysis was performed on clinical data of 62 patients with post-traumatic epilepsy treated microsurgicallly from November 2005 to May 2009. There were 48 males and 14 females, at age range from 11 to 48 years old (average 28.8 years old). The epileptogenic nidus in 59 patients was localized based on clinical manifestations, visual electroencephalography (V-EEC) imaging and electrophysiological findings and that in three patients localized by implanted intracranial electrodes. Under electrocorticogram (ECoG) monitoring, we resected cerebral malacia in 36 patients, removed both malacia and epileptogenic nidus in 15, and partially resected cerebral malacia combined with cortex thermocoagulation in 11. Results The follow-up for 6-33 months showed that there were 32 patients at grade Ⅰ , 17 at grade Ⅱ , nine at grade Ⅲ and four at grade Ⅳ according to Engel classification system. Conclusion V-EEG is an important method for pre-operative localization of epileptogenic nidus of post-traumatic epilepsy. Microsurgical management can attain favorable outcome under ECoG monitoring.

AIM　To investigate protective effects and mechanism of tanshinones on ischemia-like injury models. METHODS　Six ischemia models including hypoxia, hypoglucose, oxidant injury, caffeine injury, nitric oxide neurotoxicity and excitatory amino acid injury were used to assay the anti-ischemic roles of tanshinones in cultured primary cortex neurons. The changes of injuried cortex neurons were observed by the way of morphological examination, and live neurons of crystal violet staining were measured according to absorbent index. RESULTS　It was found that tanshinones possessed obvious protective effects on primary neurons in injury models by the way of morphological examination. Crystal violet staining also indicated that tanshinones increased number of live neurons in injury models significantly. The protective effects of tanshinones on models of oxidant injury, caffeine injury and NMDA injury were superior to other injury models. CONCLUSIONS　83.0 μmol*L-1 tanshinones protected rat cortex cells from all injury models effectively in vitro.

Objective The infection of hepatitis B virus(HBV),which is a hepatotropic DNA virus,can cause acute or chronic viral hepatitis and further may develop liver fibrosis,cirrhosis and even hepatocellular carcinoma. In recent years,with the establishment of HBV transfection cell and animal models,the anti -hepatitis B virus effect of ingredients extracted from many traditional Chinese medicine has been proved.Therefore,chemical composition extracted from the resourceful library of traditional Chinese medicine,with high efficiency and low toxicity,might be the direction for developing anti -hepatitis B virus medicine.

BACKGROUND:Healthy human umbilical cord jel y is a mucous connective tissue without vessels and has been used in eye plastic operation because of its elasticity and toughness. It contains lysozyme, placental globulin, hyaluronic acid enzyme, AMP antibody and complement, and also contains a lot of mesenchymal stem cells, so it is not prone to infection and rejection. OBJECTIVE:To observe the histocompatibility and histopathological changes of human umbilical cord jel y as a tarsal substitute transplanted for eyelid reconstruction in guinea pigs. METHODS:The mucous connective tissue of healthy neonate umbilical cord jel y was made into tissue blocks at even thickness. Models of tarsal defects were established in guinea pigs, and then the mucous connective tissue of healthy neonate umbilical cord jel y was implanted. Samples of implanted materials were col ected for histological examination at 1, 2, 3 weeks postoperation under light microscope. RESULTS AND CONCLUSION:There were no obvious rejection, infection and eyelid deformation observed, the corneas of al the animals were clear, corneal epithelial shedding did not occur, and the eyelid could move normal y. One week after implantation, there was no infection and rejection on the conjunctiva and the incision of the eyelid, the eyelid could move normal y, and partial inflammatory cells were observed between the human umbilical cord jel y and the muscle of the eyelid with microscopy. Two weeks after implantation, there was no infection and rejection on the conjunctiva and the incision of the eyelid, the cornea was clear, the eyelid and eye could move normal y, and no symblepharon occurred;umbilical cord jel y showed the tendency of absorption, and the inflammatory cells were reduced at 2 weeks after implantation. Three weeks after implantation, the incision of the conjunctiva healed wel , the cornea was clear;there was no difference in the eyelid form and movement between the two eyes;the umbilical cord jel y was absorbed partial y, normal fibrous tissues formed and there were no inflammatory cells. With low immunogenicity, human umbilical cord jel y can guide the growth of new col agen and serve as an ideal tarsal substitute.