Objective:To investigate the protective effect of dagglitazine on cardiovascular and renal function in patients with type 2 diabetes mellitus.Methods:A total of 200 patients with type 2 diabetes patients with poor blood glucose control who received treatment in Huxi Hospital Affiliated to Jining Medical University (Shanxian Central Hospital) from January to December 2019 were included in this study. They were randomly assigned to receive treatment with either metformin ( n = 100, control group) or dagglitazine ( n = 100, observation group) based on diet control and exercise therapy for 12 weeks. Before and after treatment, blood glucose, blood lipid, blood pressure, body mass index, cardiac function and renal function were compared between the control and observation groups. Adverse reactions were also monitored in each group. Results:After treatment, blood glucose, blood lipid, body mass index, cardiac function and renal function in each group were improved compared with before treatment (all P < 0.05). Fasting blood glucose, 2-h postprandial blood glucose, glycosylated hemoglobin, systolic blood pressure, diastolic blood pressure, total cholesterol, triglyceride, low density lipoprotein cholesterol, body mass index, left ventricular end diastolic diameter, serum creatinine, uric acid and cystatin C in the observation group were (6.48 ± 0.72) mmol/L, (8.03 ± 0.77) mmol/L, (6.16 ± 0.63)%, (126.03 ± 3.86) mmHg, (75.62 ± 2.87) mmHg, (3.83 ± 0.17) mmol/L, (2.21 ± 0.36) mmol/L, (2.34 ± 0.15) mmol/L, (23.03 ± 0.55) kg/m 2, (52.10 ± 2.13) mm, (39.97 ± 1.62) μmol/L, (237.17 ± 20.34) μmol/L, (0.64 ± 0.06) mg/L, respectively, which were significantly lower than (8.01 ± 0.84) mmol/L, (10.03 ± 0.90) mmol/L, (7.30 ± 0.72)%, (130.06 ± 4.79) mmHg, (79.60 ± 3.19) mmHg, (4.67 ± 0.37) mmol/L, (2.51 ± 0.57) mmol/L, (2.74 ± 0.19) mmol/L, (24.03 ± 0.60) kg/m 2, (57.22 ± 1.74) mm, (80.00 ± 6.88) μmol/L, (281.62 ± 40.52) μmol/L, (0.76 ± 0.09) mg/L, t = 13.850, 16.866, 11.933, 6.549, 9.263, 20.879, 4.469, 16.982, 12.410, 18.634, 10.626, 9.804, 18.876, all P < 0.001). After treatment, high density lipoprotein cholesterol, left ventricular ejection fraction, and the average distance walked by patients during the 6-min walk test in the observation group were (2.47 ± 0.15) mmol/L, (39.97 ± 1.62)%, (366.50 ± 17.74) m, which were significantly superior to those in the control group [(1.70 ± 0.20) mmol/L, (36.77 ± 1.21)%, (323.70 ± 12.48) m, t = 30.255, 16.435, 19.733, all P < 0.001). There was no significant difference in the incidence of adverse reactions between the two groups ( P > 0.05). Conclusion:Dagglitazine protects cardiovascular and renal function by reducing blood glucose, blood pressure, blood lipid, serum creatinine, serum uric acid levels and decreasing body mass index in patients with type 2 diabetes mellitus.

ObjectiveTo evaluate prognostic factors and the surgical results of pulmonary carcinoid tumors.Methods We retrospectively reviewed the medical records of 62 patients who were diagnosed as pulmonary carcinoid tumors between January 2000 and October 2010 at Department of Thoracic Surgery,Shanghai Chest Hospital.The following information was available for each of the 62 patients:age,sex,pathological type,and TNM stage.ResultsThere were no operative death.The 3-year and 5-year survival rates after surgery were 92.1％ and 77.8％,respectively.Of the 62 patients,42 were diagnosed as typical carcinoid tumor,and among them,4 patients (8.3％) had lymph node metastases.Their 3-year and 5-year survival rates were 97.8％ and 94.7％,respectively.The remaining 20 patients were diagnosed as atypical carcinoid tumor,and among them,6 patients (37.5％) had lymph node metastases.Their 3-year and 5-year survival rates were 84.4％ and 58.8％,which were statistically significant compared with typical carcinoid tumor( P =0.0047 ).There was significant difference in survival rate between the patients with lymph node metastases and the patients without lymph node metastases (P =0.0048).CondusionThe main risk factors affecting survival rate of those patients who were diagnosed as pulmonary carcinoid tumors were pathological types and lymph node metastases.

Transarterial chemoembolization (TACE) is a standard treatment for Barcelona Clinic Liver Cancer stage B hepatocellular carcinoma (HCC),and TACE has already been widely accepted in clinical practice.Recently,more and more researches have indicated that TACE,as a palliative therapeutic regimen,carries certain defects,e.g.after several times of TACE treatment the HCC lesions become poorly-controlled.Therefore,some scholars put forward the concept of "TACE refractory".This paper aims to make a further discussion on the concept of TACE refractory and its treatment.

Background and purpose:Loss or altered expression of Ras association domain family 1A gene (RASSF1A) through DNA methylation has been associated with the pathogenesis of a variety of cancers, which suggests the tumor suppressor function of this gene. This study aimed to explore the effect of DNA methyltransferase inhibitor 5-Aza-2’deoxycytidine (5-Aza-dc) on demethylation and expression of RASSF1A in cervical cancer cell lines. Methods:HPV positive cervical cancer cell lines HeLa and Caski, HPV negative cell lines HT-3 and C-33A were treated with two different concentration of 5-Aza-dc (5 μmol/L, 10 μmol/L). MSP (methylation-specific PCR) and Bisulfite genomic sequencing PCR (BGS) combined with TA clone were used to investigate methylation status of RASSF1A gene promoter and exon 1 before and after treatment of 5-Aza-dc. RASSF1A gene mRNA expression was detected by RT-PCR. Results:Two HPV positive cell lines showed hypomethylated RASSF1A promoters and expressed RASSF1A mRNA, and after treatment with 5-Aza-dc, the mRNA expression of RASSF1A did not change significantly (FHeLa=3.003, P=0.125; FCaski=0.045, P=0.956). Two HPV negative cervical cancer cell lines showed hypermethylation status of RASSF1A promoter and silenced RASSF1A. After treatment with 5-Aza-dc, demethylation occurred in the promoter region of RASSF1A gene, which subsequently induced re-expression of this gene in HT-3 and C-33A. The F test (FHT-3=18.002, P=0.03;FC-33A=17.179, P=0.03) and LSD-t test (P<0.05) demonstrated that significant difference in the expression of RASSF1A was found upon two different concentrations drug treatment.Conclusion:The methylation status of promoter and exon 1 of RASSFIA gene in HPV positive and HPV negative cervical cancer cell lines are different. The promoter hypermethylation is correlated with RASSF1A gene expression in HPV negative cervical cancer cell line HT-3 and C-33A, and plays a key role in RASSF1A silencing. 5-Aza-dc may effectively reverse the methylation status of RASSFIA gene promoter in cervical cancer HT-3 and C-33A cells and reactivate gene expression silenced by aberrant hypermethylation in a dose-dependent manner within certain extent.

OBJECTIVETo prepare freeze-dried long-circulation oridonin liposomes with optimized parameters.

METHODSEthanol injection method followed by freeze-drying was used to prepare the liposomes. Sephadex column was used to purify liposomes. Effects of formulation factors on entrapment efficiency of long-circulation oridonin liposomes were studied. The particle size, distribution and in vitro release were determined. Pharmacokinetics of oridonin liposomes in rats was determined by HPLC and the pharmacokinetic parameters calculated by Kinetica(TM) software were compared with conventional oridonin liposomes and solution.

RESULTSThe optimized lipid formulation for long-circulation liposomes was composed of soy lecithin, cholesterol and DSPE-PEG 2000 with a ratio of 1:0.5:1.8(w/w). The ratio of drug to lipid was 1:6. Freeze-drying protectant was a mixture of glucose and mannitol (3:1). The entrapment efficiency (EE) of long-circulation oridonin liposomes was about 65%. The particle size of liposomes after hydrolyzation was 164 nm with good DPI. The liposomes showed a sustained drug release in vitro. Intravenous injected oridonin fitted with two-compartment pharmacokinetic model. The MRT of long-circulation liposomes was 2 times and 6 times and AUC was about 2 times and 3 times of conventional liposomes and oridonin solution, respectively.

CONCLUSIONFreeze-dried liposomes with high EE have been obtained by the proposed approach. This long-circulation liposomes extend oridonin half time and significantly increase AUC in rats.

Animals ; Delayed-Action Preparations ; Diterpenes, Kaurane ; administration & dosage ; pharmacokinetics ; Drug Stability ; Freeze Drying ; Liposomes ; administration & dosage ; pharmacokinetics ; Male ; Rats ; Rats, Sprague-Dawley ; Tissue Distribution

Objective To investigate the clinical effect of modified Danggui-Sini decoction combined with Mecobalamin on diabetic peripheral neuropathy. Methods A total of 104 patients with diabetic peripheral neuropathy from January 2015 -2016 year in December in our hospital patients were randomly divided into study group and control group, each of 52 patients. The control group was given Mecobalamin 0.5 mg/times. The study group was given modified Danggui-Sini decoction plus the intervention of the observation group. Four weeks were a course of treatment. The clinical effect rates, the incidence of adverse events, change of common peroneal nerve conduction velocity, hemorheological indexes and advanced glycation end products (AGEs) were compared between the two groups before and after treatment. Results The total effective rate of the study group was 96.2%, which was significantly higher than 82.7% of the control group (χ2=4.981, P<0.05). During treatment, the incidence of adverse events was 5.8% in the study group, and the incidence of adverse events in the control group was 3.9%. There was no significant difference in the incidence of adverse reactions between two groups(P<0.05).After treatment,the motor nerve conduction velocity(49.1 ± 4.5 m/s vs.42.8 ± 4.3 m/s) and sensory nerve conduction velocity (40.1 ± 3.7 m/s vs. 36.5 ± 3.9 m/s) in the study group were significantly higher than those in the control group (t=2.732, 2.723, P<0.05). The whole blood viscosity [(3.72 ± 0.58)mPa?s vs.(4.55 ± 0.47)mPa?s],plasma viscosity[(1.03 ± 0.12)mPa?s vs.(1.78 ± 0.09)mPa?s],erythrocyte blood pressure(31.23% ± 3.19% vs.37.33% ± 4.12%),AGEs(58.44 ± 4.87 ng/L vs.68.03 ± 4.98 ng/L)in the observation group were significantly lower than those in the control group (t=2.704, -2.682, -2.737, -2.856, P<0.05). Conclusions The modified Danggui-Sini decoction combined with Mecobalamin on diabetic peripheral neuropathy can improve peripheral nerve conduction velocity, improve curative effect, showed fewer adverse events.

Objective: To evaluate the safety and efficacy of transurethral enucleation of bladder tumor(TUEBT) in the treatment of non muscle-invasive bladder cancer (NMIBC). Methods: The clinical and pathological data of 82 NMIBC patients treated between No-vember 2015 and January 2018 in the First Affiliated Hospital of the Jinzhou Medical University were retrospectively analyzed. The 82 NMIBC patients were divided into a TUEBT group (38 cases) and a transurethral resection of bladder tumor (TURBT) group (44 cases). The differences in intraoperative indices, postoperative indices, and pathological staging between the two groups were compared. Re-sults: The bladder irrigation, indwelling catheter, and postoperative hospitalization times in the TUEBT group were (21.00 ± 3.55) h, (4.34±0.81) d, and (5.29±0.96) d, respectively, compared with (27.57±3.87) h, (5.32±0.83) d, and (6.32±0.86) d in the TURBT group, and the differences between groups were statistically significant (P<0.05). The operative time in the TUEBT group [(29.55±4.13) min] was longer than in the TURBT group [(25.30±4.01) min]. The hemoglobin decrease in the TUEBT group [(2.00±0.38) g/dL] was less than that in the TURBT group [(2.30±0.32) g/dL]. The incidence of obturator nerve reflex in the TUEBT group was 13.16% (5/38), compared to 34.09% (15/44) in the TURBT group. The recurrence rate in the TUEBT group was 10.53% (4/38), compared to 29.55% (13/44) in the TURBT group. The detrusor deletion rate in the TUEBT group was 0 (0/38), compared to 31.82% (14/44) in the TURBT group. The re-peat transurethral resection (ReTUR) standard was met in 22 cases in the TUEBT group and 33 in the TURBT group. ReTUR due to lack of a detrusor was required in 0 cases in the TUEBT group and 14 in the TURBT group. The differences in the above clinical characteris-tics were statistically significant (P<0.05). Conclusions: TUEBT can remove a tumor completely, while preserving the detrusor, improv-ing the accuracy of pathological staging, and reducing the probability of ReTUR. For NMIBC, TUEBT can obtain satisfactory clinical effi-cacy, with surgical safety and long-term efficacy superior to those of TURBT.

Objective To investigate ablation characteristics of PVC/VT originating from left ventricle anterior papillary muscles.Methods This study included 10 patients of PVC/VT originating from left ventricle anterior papillary muscles from January 2015 to June 2016 in Beijing Anzhen Hospital.Electrophysiological mapping and radiofrequency ablation were completed using three-dimensional anatomical mapping system combined with three-dimensional intracardiac ultrasound technology.ECG and abaltion target diagram characteristics as well as the special anatomy were explored.Results All the 10 patients were successfully ablated and followed up for 12 months.One patient had recurrence within 12 months and no complications were recorded.The target sites localized at the tip (n =1),middle portion(n =4)or the base (n =5) of the LV-APM.Among 7 patients,the target sites were located at the anterior septal papillary muscle and in 3 patients were located in the free papillary muscle.9 patients were successfully ablated via anterograde trans-septal catheterization after the failure of retrograde approach.Premature QRS wave time were 152.80 ± 11.72 ms and 6 patients presented sharp potential at the targets during PVC/VT.Conclusions PVC/VT originating from left ventricle anterior papillary muscles have similar ECG and diagram characteristics that is different from which originating from left anterior fascicle.It is recommended to get the target via transseptalpuncure approach.Ablation target could be clearly positioned by three-dimensional intracardiac ultrasound technology.

Objective The recurrence of perimitral atrial tachycardia is common after initial ablation of persistent atrial fibrillation (AF). The aim of the study is to explore a preferable ablation approach for perimitral atrial tachycardia in the redo ablation of persistent AF. Methods Seventy-four patients with perimitral atrial tachycardia after initial ablation for persistent AF were included in our study. Patients were distinguished into either the group of having ablation during tachycardia (Group A) or the group having ablation after cardioversion to sinus rhythm (Group B) according to the different ablation strategies. The procedural endpoints were pulmonary vein isolation and bidirectional conduction block of all the ablated lines. The primary endpoint of the study was freedom from atrial tachyarrhythmia recurrence during the follow-up period. Results There were statistical differences in baseline clinical data between the 2 groups. During the redo procedure, conduction recovery rate across the mitral isthmus (MI),cavotricuspid isthmus and left atial roofline were 100％, 40.5％ and 48.6％ respectively. The procedural time, fluoroscopy time, mapping time were longer in the patients of group A. During a mean follow-up of (16.9±6.3) months, 31 (72.1％) patients in group A and 21(67.7％) patients in group B maintained in sinus rhythm in the absence of antiarrhythmic durgs (P =0.771) . Conclusion In patients with perimitral atrial tachycardia after initial ablation for persistent AF,ablation in sinus rhythm is a more simplified method and as effective as ablation during tachycardia.

Objective To identify the electrophysiological charateristics and cause of ridge gap related reentry after MI ablation in atrial ifbrillation patients. Methods Activation and entrainment mapping was performed in 82 redo cases for OAT recurrence in whom MI was ablated during the index produre. Once ridge gap related reentry was conifrmed, detailed mapping was performed in MI and ridge region. In addition, in 36 cases undergoing MI ablation and fulfilling criterion for bidirectional block, differential pacing was repeated at the ridge to identify a ridge gap. Results Out of 82 redo cases for OAT recurrence in whom MI was ablated during the index produre, 7 (8.5%) was found to be ridge gap related reentry. TCL was (247.9±19.2) ms, and the left atrial endocardial activation time was (145.4±17.7) ms, accounting for (58.5±3.2)%of TCL. However, wide double potential was recorded along the previous ablated MI line where PPI was (34.3±6.6) ms longer than TCL, while PPI was signiifcantly shorter at the ridge[PPI-TCL (11.4±3.9) ms, P<0.001]. Tachycardia was terminated at the ridge in 6 cases and at the corresponding site in coronary sinus in 1 case. No recurrence was found during follow-up for (11.1±4.5) months. In addition, in 36 patients undergoing MI ablation in whom criterion of bi-directional block was fuliflled, conduction gap located at the ridge was found in 5 (13.9%) cases. Conclusions MI ridge gap related reentry is a distinctive OAT, in which the ridge was used as the critical isthmus, whereas the previous ablated MI line is not part of the reentry. MI pseudo-block due to the ridge gap may lead to this type of recurrent tachycardia.