Vildagliptin is a potent and specific inhibitor of dipeptidyl peptidase 4,which has been implicated to enhance and prolong the physiological actions of incretion hormones including glucagon-like peptide-1 and glucose-dependent insulinotropic polypeptide.Vildagliptin is an orally administered drug and has been licensed for the treatment of type 2 diabetes mellitus.Vildagliptin monotherapy or in combination with other drugs can effectively lower glycosylated haemoglobin levels to a great extent.In addition,vildagliptin acts in a glucose-dependent manner,explaining its low risk of hypoglycemia.This drug has been proved well tolerated with few gastrointestinal side effects or oedema.Therefore vildagliptin is a promising new option for type 2 diabetic patients,and these patients would achieve better glycemic control and fewer complications in the long run.

OBJECTIVETo study the applied value of double joystick technique in reduction-internal fixation for femoral shaft fracture in adults.

METHODSThirty-four patients (24 males and 10 females) with femoral shaft fractures were treated with reduction assisted by double joystick technique and internal fixation with interlocking intramedullary nail from September 2010 to June 2013. The average age of the patients was 41 years old, ranged from 17 to 65 years old. The duration of the disease course ranged from 3 to 7 days, with a mean of 5 days. The fractures belonged to AO types 32A (5 cases), 32B (20 cases) and 32C (9 cases) and located in left femur for 18 patients and right femur for 16 patients. The patients were followed up, and fracture healing and complications were observed. The curative effect were evaluated according to Thorsen femur fracture evaluation standard.

RESULTSThe operative time ranged from 40 to 110 min (mean 75 min) and intraoperative blood loss ranged from 200 to 300 ml (mean 250 ml). All the patients obtained a good fracture reduction and were followed up for 12 to 24 months (mean 18 months) after the surgery. All the fractures united between 4 and 8 months with a mean of 5 months. No complications such as breakage of nail, infection, osteofascial compartment syndrome, refracture and fracture malunion were found. According to Thorsen femur fracture evaluation standard, 30 patients obtained an excellent result, 3 good and 1 fair.

CONCLUSIONIn surgery of reduction-internal fixation for femoral shaft fracture in adults, the use of double joystick technique obtains good reduction result, short operative time, less injury, high healing rate of bone fractures, less complications and good limbs function, so it is worthy of popularizing in clinic.

Adolescent ; Adult ; Aged ; Bone Nails ; Female ; Femoral Fractures ; physiopathology ; surgery ; Fracture Fixation, Intramedullary ; instrumentation ; methods ; Fracture Healing ; Humans ; Male ; Middle Aged ; Young Adult

ObjectiveTo explore the influence of life events on the emotional state ot heart transplantation patients.Methods All the heart transplantation outpatients were interviewed by a certain psychiatrist in Zhongshan Hospital during Oct.2010 to Oct.2011.The demographic data,life events and the self-reported influenced degree were recorded by the same psychiatrist.A grounded theory-based approach with thematic content analysis of the field notes was used.ResultsEighty-eight patients were enrolled,including 69 males,and19 females.The average age of the patients was 46.5 ±14.3 years old.The average duration after operation was 39.3 ± 39.6 months.The life events were classified into 4 groups,which were medical financial problems,physical condition,family support and future life.The most frequently reported event was physical condition (50.2％ ) and the influenced degree was the highest (9.2 ±1.2),while most patients (96.6％) complained high medical and relevant cost and the influenced degree was (6.5 ± 2.1). Family support was reported by13.6％ patients and its influenced degree was (7.6 ±1.2).The age of the reporter of future life (6.8％) was under 33 years.ConclusionDifferent events have different influence to patients.Improving the social support of patients is helpful to improve quality of life.

0.05).There were significant differences among group B,group D and group E(P

Objective To investigate the effect of diazepam on blood-brain barrier ( BBB ) after radiation-induced brain injury. Methods Two hundred and forty healthy male SD rats weighing 240-270 g were randomly divided into 4 group with 60 animals in each group: Ⅰ D-R group received intraperitoneal diazepam 5 mg?kg-1 30 min before irradiation; Ⅱ N-R group received no diazepam before irradiation; Ⅲ D-SR group received intraperitoneal diazepam 5 mg? kg-1 30 min before sham irradiation and Ⅳ N-SR group received no diazepam before sham irradiation. The animals were placed in a prone position awake without any anesthetics. The whole brain was irradiated by 4 MeV electron beam at a single dose of 30 Gy. The changes in BBB were assessed by (1) magnetic resonance imaging (MRI) with the T1-weighted images, T2-weighted images and MRI enhancement images induced by Gd-DTPA; (2) Evans blue (EB) assay; 2% EB 3 ml?kg-1 was injected via femoral vein and 3 h later the animals were decapitated and EB content in the brain tissue was determined by spectrophotometry; (3) The expression of vascular endothelial growth factor (VEGF) in the brain tissue determined by immuno-histochemistry before irradiation ( T0 ) ( baseline) at 6 h (T1 ), 1 day ( T2 ) , 1 week ( T3 ) and 1 month ( T4 ) after irradiation.Results In group Ⅱ (no diazepam before irradiation) the signal intensity of T1-weighted images significantly decreased while the signal intensity of T2-weighted images and the enhancement rate significantly increased at T4. However in group Ⅰ (diazepam was given before irradiation) the changes in the MRI were significantly attenuated. The EB content at T1, T3 , T4 and the expression of VEGF at T1 , T, were significantly higher in group Ⅱ than in group Ⅰ . Conclusion Diazepam given before irradiation can protect BBB against irradiation injury by decreasing the expression of VEGF in the brain tissue and BBB permeability.

Objective To study the chemical constituents in the seeds of Zizyphus jujuba var.spinosa.Methods The compounds were isolated by silica gel column chromatography and their structures were established by spectroscopic methods.Results A new keto-dammarane type saponin,jujuboside H(Ⅰ),along with three known compounds protojujuboside A(Ⅱ),spinosin(Ⅲ),and betulic acid(Ⅳ)were isolated.Conclusion Compound Ⅰ is a new compound named jujuboside H.

Objective To evaluate the expression of Fas Ligand (FasL) on gastric T cell during H.pylori infection and its cytotoxicity to gastric epithelial cells. Methods FasL protein expressions on mono nuclear cells of gastric mucosa with and without H.pylori infection were examined by immunohistochemistry assay. FasL mRNA expressions were detected in gastric T cell lines isolated from H.pylori infected and uninfected gastric biopsies by RT PCR. The function of FasL expressed by gastric T cells to induce apoptosis in Fas bearing cells was determined by a co culture bioassay (JAM), while the Fas mediated apoptosis of gastric epithelial cells induced by gastric T cells were also evaluated by the same assay. Results FasL was expressed by the mononuclear cells accumulated in gastric mucosa with H.pylori infection, whereas the few mononuclear cells presented in uninfected gastric tissues were negative for FasL. FasL mRNA was detected in gastric T cells isolated from H.pylori infected gastric biopises, while that of uninfected gastric T cell lines was either negative or weak positive. Gastric T cells were capable of inducing apoptosis of Fas positive jurkat cells, while this could be blocked by Fas blocking antibody, ZB4. Conclusions T cells presented in gastric mucosa during H.pylori infection could damage gastric epithelium through Fas/FasL interaction.

Objective To construct a recombinant strain which expresses adhesin AlpA of Helicobacter pylori(H.pylori) and to study the immunogenicity of adhesin AlpA. Methods The adhesin AlpA DNA was amplified by PCR and inserted into the prokaryotie expression vector pET-22b(+)and expressed in the BL21(DE3) E.coli strain. Adhesin AlpA immunogenicity was studied by Western blot test. Results DNA sequence analysis showed that the sequence of adhesin AlpA DNA was almost the same as that of the published by GenBank. The adhesin AlpA recombinant protein accounted for 31.9% of the total bacterial protein. Western blot analysis of rAlpA confirmed that it could be specially recognized by serum from rabbit immunized with AlpA itself and H.pylori infected patients. Conclusion Cloning and high-expression of adhesin AlpA and primary confirmation of its immunogenicity lay the foundation for H.pylori gene engineering vaccine preparation and adhering mechanism research.

The newly-formed TCM medical group is characteristic of innovative management,diversified medical service provision,integration of medical resources,building of urban/rural medical service systems,promoting medical resources availability to primary care,perfecting hierarchical medical service mechanism,leveraging advantages of traditional Chinese medicine and its primary care capabilities,centralizing human,financial,and material resources management.

Tumor immunotherapy is highlighted in tumor studies and has a remarkable curative effect on tumors. Programmed cell death-1 (PD-1), which is mainly expressed in activated T and B cells, is an important immune inhibitory molecule. Its ligand PD-L1 could be highly expressed in cancer cells, and the PD-1 pathway shows sustained activation in a tumor micro-environment. PD-1/PD-L1 inhibitors can block the combination of PD-1 and PD-L1, inhibit negative to regulatory signals, and restore the activity of T cells, thereby enhancing immune response. Recent studies showed that PD-1 and PD-L1 inhibitors have been effective in many tumor types. This review summarizes PD-1/PD-L1 inhibitors and their clinical effects on different tumor types.