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.

Objective To detect the value of autoantibedy profile in primary biliary cirrhosis (PBC). Methods 96 serum samples of patients with primiary biliary cirrhosis, 100 serum samples of other antoimmune disease and 49 serum samples of healthy were tested for anti- M2, anti-3E(BPO), anti-Sp100,anti-PML,anti-gp210,anti-LKM-1 ,anti-LC-1 ,anti-SLA/LP by EUROLine. Results The positive of the anti-M2,anti-BPO, anti-Sp100, anti-PML and anti-gp210 for PBC was 76. 0%, 84.4%, 32. 3%, 28. 1% and 35.4% ,respectively. The positive of the anti-M2, anti-BPO, anti-Sp100, anti-PML and anti-gp210 for other autoimmune disease was 13.0% ,9. 0% ,3.0% ,2.0% and 1. 0%, respectively. The sensitivity of the anti-M2 for PBC was 76. 0% ,with specificity of 87. 0%. The sensitivity of the anti-BPO for PBC was 84. 4%, with specificity of 91.0% ;the sensitivity of the anti-Sp100 for PBC was 32. 3%, with specificity of 97.0%. The sensitivity of the anti-PML for PBC was 28. 1% ,with specificity of 98.0%. The sensitivity of the anti-gp210 for PBC was 35.4%, with specificity of 99. 0% . Anti-LKM-1, anti-LC-1, anti-SLA/LP positive patients with PBC were not detected;the incidence rate of liver function failure in anti-gp210 positive serum higher than anti-gp210 negative serum (χ2 = 11.17, P < 0. 01). Conclusions Multiple autoantibedies can be detected in the sera of PBC patients. The detection of autoantibody profile is useful for the diagnosis and differential diagnosis of PBC, and may he helpful for therapy and prognosis of PBC.

Objective To investigate the relationship between the PTPN22 gene polymorphism and rheumatoid arthritis(RA).Methods Real time fluorescent quantitation PCR was used to detect the 1123G＞C polymorphism of the PTPN22 gene from 200 RA patients,100 others rheumatic diseases and 200 the normal controls.The results were analyzed by SPSS 11.0 software.Results The CC genotype frequencies of RA patients.others rheumatic diseases and the normal controls were 0.120,0.020 and 0.015 respectively.There was a significant difiefence between BA patients and others rheumatic diseases (X=18.708.P＜0.01).1'here Wag a significant difference between RA patients and the normal controls(X2=24.337,P＜0.01).There was not statistically significant between others rheumatic diseases and the normal controls(X2=1.066,P＞0.05).The C allele frequency of RA patients,others rheumatic diseases and the normal controls were 0.360.0.190 and 0.215 respectively.The results were significant difference.Conclusion The PTPN22 gene could be one of predisposing genes and the therapeutic target genes with RA patients.

Objective To detect the expression of TGF-β1 mRNA and ERβwt mRNA in peripheral blood monoanclear cells (PBMCs) in patients with chronic fatigue syndrome (CFS), and their relationship with pathogenesis of CFS. Methods Fluorescence quantitative RT-PCR (FQ-RT-PCR) was used to examine TGF-β1 mRNA and ERβwt mRNA expression of peripheral blood monocytes in 63 cases with CFS,50 cases with other diseases, and 50 healthy controls. The gene expression levels were calculated with the formula △Ct=Ct(target gene) - Ct(internal control). Results The mean TGF-β1 mRNA expression of CFS patients (△Ct = 3.27 ± 0. 58) was higher than that of disease controls (△Ct = 4. 54 ± 1.05, t = 8. 11, P <0.01) and that of healthy controls (△Ct = 4. 37 ± 1.00, t = 7. 02, P < 0. 01). The mean ERβwt mRNA expression of CFS patients (△Ct =9. 34 ±0. 92) was lower than that of disease controls(△Ct =7.12±0. 47, t = 15.44 ,P < 0. 01) and that of healthy controls(△Ct = 7. 10 ±0. 48, t = 15.47, P < 0. 01). Conclusions The TGF-β1 mRNA and ER βwt mRNA expression levels of PBMCs are siguificantly elevated in patients with CFS. It may be implicated in the pathogenesis of CSF.

Objectlve To detect the expression of CXCR3 mRNA in peripheral blood mononuclear cells (PBMC) in patients with primary biliary cirrhosis (PBC) ,and explore its relationship with activity of PBC.Methods Reverse transcription-real time quantitative polymerase chain reaction (FQ-RT-PCR) was used to examine CXCR3 mRNA expression in peripheral blood monocytes of 29 cases of PBC in active stage. 30 cases in stable stage,20 cases in CTD,and 30 healthy controls.Results The mean level of CXCR3 mRNA expression of PBc inactive stage (△Ct=5.41±2.69) Was higher than that of stable stage (△Ct=7.77±2.74,t=3.39,P＜0.01),CTD(△Ct=7.24±2.75,t=2.53,P＜0.01),and healthy controls (△Ct =7.16±2.76,t=2.45,P＜0.01).There was no significant difference of expression levels of CXCR3 mRNA among stable stage PBC patients,CTD diseases patients and healthy controls (P＞0.05).Conclusion This study indicated that the CXCR3 mRNA expression levels of PBMC is significantly elevated in patients with active PBC.and it could be implicated in pathogenesis and activity of disease.

Objective To detect the expression of GITR mRNA in peripheral blood mononuclear cells (PBMCs) of patients with primary biliary cirrhosis (PBC) and its relationship with the disease activity of PBC.Methods Real time quantitative reverse transcription polymerase chain reaction (FQ-RT-PCR) was used to examine GITR mRNA expression on peripheral blood monocytes of 44 active PBC, 34 stable PBC, 30.hepa-toma cases and 30 healthy controls. Results The mean GITR mRNA expression of active PBC (△Ct=10.5±

Objective To explore the relationship of Toll-like receptors (TLR)-3 Mrna expression level on peripheral blood monocytes (PBMCs) with disease activity of PBC in patients with primary biliary cirrhosis (PBC). Methods The expression level of TLR-3 Mrna on peripheral blood monocytes was tested in 55 PBC cases (33 cases in active phase, 22 cases in stable stage), 20 cases with hepatoma (as disease controls) and 24 healthy controls. By real-time quantitative reverse transcription polymerase chain reaction (FQ-RT-PCR) methods. Β-actin was selected as the internal control. △Ct=Ct (target gene)-Ct(internal reference gene) were used to measure the gene expression level. Results The mean TLR-3 Mrna expression of PBC in active stage was higher than that of stable stage, hepatoma (P<0.001) as well as normals.The difference was significant (P=0.011<0.05). The mean TLR-3 Mrna was not different than that of the stable stage (P=0.221>0.05) and normal controls (P=0.347>0.05). There was no difference between patients with stable PBC and normal controls (P=0.590>0.05). Conclusion The TLR-3 Mrna expression level of PBMCs is elevated in active PBC patients. It may correlate with the pathogenesis and disease activity of PBC.

Lysophosphatidylcholine acyltransferase 1(LPCAT1),a key metabolic enzyme in the phosphatidyl-cho-line metabolism pathway,mediates phosphatidylcholine synthesis through deacylation-reacylation,which leads to alterations in the phospholipids composition of cell membranes and the remodelling of the cellular cytoskeleton.Ly-sophosphatidylcholine acyltransferase 1 has been shown to be highly expressed in gastric,breast and colorectal cancer,and can accelerate the alteration of the phospholipids composition of tumor cell membranes or interact with tumor driver genes,such as epidermal growth factor receptor and cell cycle-related genes.It might promote tumor development by affecting tumor cell proliferation,migration,invasion and resistance to chemotherapy.

Objective A comprehensive evaluation of oral anticoagulants(OACs)was conducted using the A Quick Guideline for Drug Evaluation and Selection in Chinese Medical Institutions(the Second Edition),to provide a reference for drug selection and clinical medication decisions in medical institutions.Methods Evaluation evidence was collected,and the drugs included in the evaluation were quantified on four dimensions of clinical properties(efficiency and safety),pharmaceutical properties,economy and others.Results All oral anticoagulants included in the evaluation had a score of 70 or higher in the comprehensive evaluation,while warfarin had the highest overall score.Clinical properties and pharmacologic properties were identified as the core attributes for drug selection evaluation.When considering only these factors,edoxaban received the highest score.Conclusion OACs are the preferred option for patients requiring long-term anticoagulation therapy.Various OACs offer distinct clinical advantages.Utilizing the Guidelines(Second Edition)for oral anticoagulant selection and evaluation can offer visual evidence for drug selection and promote the scientific,rational,and safe use of drugs in clinical management.

OBJECTIVE： To standardize the management of temporary drug purchase， and to provide reference for drug selection in Hospital Pharmaceutical Administration and Drug Treatment Committee （Pharmaceutical Association）. METHODS： Clinical pharmacists set up drug quantitative scoring table according to the 10 attributes of drugs as effectiveness， safety， economy， etc. 15 temporary purchased drugs submitted by departments in Oct. 2018 were graded according to the rules of the scoring table， and the evaluation results were fed back to Pharmaceutical Association. A retrospective evaluation of 20 temporary purchased drugs which were discussed at the Pharmaceutical Association from Jul. to Sept. 2018 was made according to previous approval model without using drug quantitative scoring table. The effect of pre-intervention was evaluated after using drug quantitative scoring table. RESULTS： Among 15 temporary purchased drugs， 2 of them scored below 60， and the unqualified rate was 13.3％. It suggested that 2 drugs could not be discussed at the meeting. Among 20 temporary purchased drugs that have been discussed at the meeting， 9 of them scored below 60， with the unqualified rate of 45.0％， suggesting that 9 drugs may have wasted the workload of the Pharmaceutical Association. CONCLUSIONS： Drug quantitative scoring table can play a pre-intervention role in the scoring of temporary purchased drugs to a certain extent. At the same time， the table can also be used as a relevant reference for hospital drug evaluation. It is helpful to optimize hospital drug use list and improve the level of rational drug use in clinic.