Objective To investigate the clinical effect of sitagliptin combined with metformin in the treatment of sulfonylurea-deficient elderly patients with diabetes mellitus.Methods Sixty patients with diabetes mellitus were enrolled in our hospital from January 2013 to December 2016.The patients were divided into observation group(30 cases) and control group(30 cases) according to the random number method.The patients in the observation group were treated with sitagliptin and metformin.The patients in the control group were treated with gemcitabine, and the clinical treatment effect, fasting blood glucose, postprandial blood glucose, glycosylated hemoglobin, fasting C peptide and postprandial 2hC peptide Level of statistical comparison.Results The clinical effect of the observation group was significantly higher than that of the control group.Before and after treatment, the fasting blood glucose, 2h postprandial blood glucose, glycosylated hemoglobin, fasting C peptide and postprandial 2hC peptide level were not significantly different After fasting blood glucose, 2h postprandial blood glucose and glycosylated hemoglobin levels were significantly lower than before treatment, after treatment of fasting C peptide and postprandial 2hC peptide levels were significantly higher than before treatment.Conclusion The clinical efficacy of serotretine combined with metformin in the treatment of elderly patients with diabetes mellitus is similar to that of Yuxing, and the combination is more convenient and more suitable for clinical treatment.It is worthy to be popularized and applied in clinical practice.

Objective:To evaluate the efficacy and safety of acupuncture in the treatment of central post-stroke pain(CPSP). Methods:Randomized controlled trials of acupuncture treatment for CPSP in PubMed,Excerpta Medica Database(EMBASE),Cochrane Library,China National Knowledge Infrastructure(CNKI),Wanfang Data Knowledge Service Platform(Wanfang),Chongqing VIP Database(VIP),and China Biology Medicine Disc(CBM)were retrieved by computer.The retrieval time was from each database's inception to July 2023.Meta-analysis was performed using RevMan 5.3 software;GRADEprofiler 3.6.1 software was used to evaluate the quality of evidence.Dichotomous variables were analyzed by the risk ratio(RR).Continuous data were analyzed by mean difference(MD)with a confidence interval(CI)of 95%. Results:A total of 14 studies were included,comprising a total of 1 045 patients.The findings of the meta-analysis showed that compared with Western medication in treating CPSP,the acupuncture treatment had a higher clinical effective rate[RR=1.09,95%CI(1.01,1.19),Z=2.08,P<0.05],a lower visual analog scale(VAS)score[MD=-0.75,95%CI(-1.18,-0.32),Z=3.41,P<0.001],a lower pain rating index(PRI)score[MD=-1.72,95%CI(-2.76,-0.68),Z=3.24,P<0.05],a higher plasma β-endorphin(β-EP)level[MD=5.81,95%CI(3.00,8.62),Z=4.05,P<0.001],and a lower adverse reaction rate[RR=0.05,95%CI(0.01,0.18),Z=4.35,P<0.001].There was no statistical difference in the present pain intensity(PPI)score between the two treatments[MD=-0.26,95%CI(-0.54,0.02),Z=1.79,P>0.05].Compared with Western medication in treating CPSP,acupuncture plus Western medication had a higher clinical effective rate[RR=1.18,95%CI(1.05,1.34),Z=2.75,P<0.05],a lower VAS score[MD=-1.04,95%CI(-1.26,-0.82),Z=9.25,P<0.001],and a lower Pittsburgh sleep quality index(PSQI)score[MD=-2.67,95%CI(-4.80,-0.54),Z=2.46,P<0.05].The results of the evidence quality grade evaluation showed that there was no moderate-or high-quality evidence for acupuncture or acupuncture plus Western medication compared with Western medication in the treatment of CPSP. Conclusion:Acupuncture has certain therapeutic advantages over Western medication in the treatment of CPSP.It can effectively relieve pain and improve sleep,with fewer adverse reactions and better safety.However,high-quality randomized controlled trials are still needed for further study and verification.

OBJECTIVETo explore the clinical effects of negative pressure wound therapy (NPWT) combined with artificial dermis grafting and autologous skin grafting on repair of open joint wounds and/or wounds with exposed bone fracture.

METHODSEleven patients with open joint wounds and/or wounds with exposed bone fracture, hospitalized from November 2008 to November 2014, were enrolled in the study. According to the differences of the first stage treatment, all patients were divided into experimental group ( n = 6, including 4 patients of open joint wounds, 1 patient of wound with exposed bone fracture, and 1 patient of open joint wound with exposed bone fracture), and control group ( n 5, including 2 patients of open joint wounds, 2 patients of wounds with exposed bone fracture, and 1 patient of open joint wound with exposed bone fracture). After debridement, the wounds in both groups were grafted with punctured artificial dermis, while NPWT was only used over the artificial dermis of experiment group for 1 week. In the operation at sacsod stage, autologous split-thickness skin was grafted on the vascularized artificial dermis in both groups. Results In 5 patients of open joint wounds in experimental group, the artificial dermis was vascularized well, autologous skin grafts survived, and wounds were healed. In 3 patients of open joint wounds in control group, the artificial dermis grafting all failed due to local infection, and then these wounds were repaired with local tissue flap grafting. Artificial dermis in 3 patients of wounds with exposed bone fracture in both groups was vascularized well after grafting, and the wounds were healed after autologous skin grafting, whether or not NPWT was used.

CONCLUSIONSNPWT combined with artificial dermis grafting and autolognus skin grafting can be used for repairing open joint wounds and/or wounds with exposed bone fracture.

Debridement ; Dermis ; transplantation ; Humans ; Negative-Pressure Wound Therapy ; methods ; Skin Transplantation ; methods ; Skin, Artificial ; Surgical Flaps ; Wound Healing

Asphyxia Neonatorum ; blood ; drug therapy ; Creatine Kinase, MB Form ; blood ; Female ; Humans ; Infant, Newborn ; Male ; Naltrexone ; analogs & derivatives ; therapeutic use ; Natriuretic Peptide, Brain ; blood ; Peptide Fragments ; blood

Objective To explore the value of multiple-mouse MRI in evaluating the therapeutic effect of endostatin for transplantation tumor models of colorectal carcinoma in mice.Methods 24 subcutaneously transplantation tumor’s models of colorectal carcinoma (CT-26) in mice were established, 1 week later, 16 tumor-bearing mice were sieved out and divided randomly into two groups: endostatin (ES) group and normal saline (NS) group, treated with intraperitoneal injection of endostatin 6 mg/kg?d 0.2 ml and equal volume of saline respectively for 14 days. Subsequently, MMMRI was performed, and then the mice were killed immediately and the tumors were cut into sections which were stained with hematoxylin and eosin (H&E). Results Subcutaneous fat layer in NS group presented thinner or disappeared on T1WI,while subcutaneous fat layer in ES group presented thicker. The tumors presented inhomogeneous high signal and intratumoral stippled necrosis on T2WI. The tumor’s volumes measured by MRI and pathology were(2723.26?1136.91) mm3 and (3505.76?1350.12) mm3 respectively,there was no difference between these two measures. And there was correlation between MRI results and pathological results. There was no difference of absolute signal intensity between ES group and NS group on T1WI and T2WI. The signal intensity ratio of ES group (3.19?0.28) was higher than which of NS group (2.60?0.47) on T2WI, and there was no difference on T1WI. Conclusion The therapeutic effect for endostatin on transplantation tumor models of colorectal carcinoma in mice can be displayed distinctly in MMMR image, and the inhibition rate of results can be displayed exactly and noninvasively.

BACKGROUND: Using color Doppler ultrasonography, renal graft size, appearance, structure, and blood flow distribution can be observed. Through the use of blood flow display technique, blood flow perfusion of renal graft can be accurately observed to assist diagnosis and differential diagnosis of complications following renal transplantation. OBJECTIVE: To observe the hemodynamic characteristics during different periods of acute renal transplant rejection, summarize its specific manifestations through analyzing different reaction of two dimensional and color Doppler flow imaging (CDFI) during renal transplantation in order to get valuable index on acute rejection of renal transplantation.DESIGN, TIME AND SETTING: Comparative observation was performed at the Jinan University and First Hospital of Shenzhen University between January 2003 and January 2007.PARTICIPANTS: A total of 299 patients undergoing renal transplantation were divided into normal allograft group (n=236) and acute rejection group (n=63) according to renal allograft function.METHODS: The systolic peak flow rate, end-diastolic flow rate, mean flow rate, pulsatility index and resistance index of main renal artery and arcuate artery in patients of two groups were compared. MAIN OUTCOME MEASURES: Renal allograft arterial inner diameter and hemodynamics of two groups.RESULTS: Compared with normal allograft group, the blood flow perfusion was reduced at acute rejection, which could not reach cortex margin, blood velocity was decreased at the diastolic phase, pulsatility index and resistance index were increased (P < 0.05). CONCLUSION: Color Doppler ultrasound, as a convenient, economical and noninvasive technique, provides the reliable evidences for the renal artery pulsatility index and resistance index in clinic, and also is valuable for the acute rejection early diagnosis of renal allograft.

Objective To evaluate effectiveness of ex vivo adenoviral gene transfer creating human bone morphogenetic protein 7-producing mesenchymal stem cells (Ad-hBMP-7 cells) compounded with nano-hydroxyapatite/collagen(NHAC) composite to induce spinal fusion in a rat posterolateral spine fusion model. Methods Mesenchymal stem cells were cultured and transduced by Ad-hBMP-7. Then Ad-hBMP-7 cells were cocultured with NHAC. Totally 56 Wistar rats were divided into four groups. Intertransverse spinal arthrodesis was attempted in four groups of Wistar rats with autogenous bone (group A); NHAC(group B); NHAC and BMSCs (group C); Ad-hBMP-7 cells and NHAC (group D). Each specimen underwent plain radiography, manual palpation and histological analysis. Results All spines in group D had fusion. In contrast, none of the spines in group A and group B had fusion. Three of ten rats in group C achieved fusion at the 12th week post-operatively.Conclusion BMP-7-producing mesenchymal stem cells compounded with NHAC composite may induce intertransverse fusion in the rat spine model.

Hepatic tumor-specific magnetic resonance (MR) enhancement with Gd-EOB-DTPA can detect and distinguish small hepatocellular carcinoma (HCC) with greater sensitivity than conventional magnetic resonance imaging and computed tomography.Hepatic tumor-specific MR enhancement with Gd-EOB-DTPA is more sensitive in detecting focal HCC,and more reliable in detecting lesions with a diameter smaller than 2cm.Gd-EOB-DTPA is excreted through the kidneys and biliary tract,and thus may provide more information about anatomic structures,demonstrate non-obstruction of the intra- and extrahepatic bile duct system,and provide information about hepatic function.

Objective To explore the value of follow-up of serum TSH stimulating thyroglobulin (Tg) test and 131I whole body scan(WBS) in patients with differentiated thyroid cancer(DTC) who were treated by 131I.Methods By SPSS software,Kappa test was performed between results of serum Tg,TgAb test and WBS for diagnosis of persistent/recurrent DTC.Results Consistency test of TSH stimulating Tg,TgAb and 131I WBS for diagnostic persistent/recurrent or metastasis of DTC:kappa value =0.587,SE =0.076,P ＜ 0.01.Although the results showed that two measurements appeared definite consistency,it is dissatisfactory.Conclusion Serum TSH stimulating Tg test and 131I whole body scan(WBS) are important follow-up tools for patients with DTC.Because of Tg interfering it is necessary to performed TgAb test simultaneously,when Tg test was performed.Especially 131I WBS do is not absent because false negative would be able to appeared in single serum TSH stimulating Tg and TgAb test.

Objective To evaluate the effect and the anti-tumor mechanism of nucleoside combination on human hepatoma cell line Bel-7402 with Arg-Gly-Asp sequence labeled by ultrasmall superparamagnetic iron oxide (RGD-USPIO).Methods The tumor cells Bel-7402 of logarithmic phlyhase were divided into experimental group and control group,treated with 1 mmol/L nucleoside combination and 1640 medium respectively.The two group were co-cultured for 48 h,and were added RGD-USPIO and co-cultured for 6 h.Then the two groups were proceeded with MR scanning,and the signal intensity of T2WI were measured.After extraction of the total RNA and protein of experiment group and control group,the expression of integrin avβ3 was detected using real-time PCR and Western blot.Results The T2WI signal intensity of experimental group (997.35±42.83) was higher than that of control group (241.05±15.36,t 28.79,P＜0.01).Compared with control group,the expression of integrin αvβ3 mRNA in experimental group was (0.22±0.02) times (t=4.50,P＜0.01).According to Western blot,the protein bands of experimental group were relatively lighter than that of control group,the expression of integrin αvβ3 in experimental group was lower (t =11.88,P＜0.01).Conclusion Nucleoside combination has anti-tumor effect by inhibiting integrin ligand-receptor binding,and the anti tumor mechanism may be related to the induction of tumor cell apoptosis.MR molecular probes can conveniently and accurately evaluate the anti-tumor effect of nucleoside combination on Bel-7402 cells.