Dipeptidyl peptidase-4 (DPP-4) inhibitors, a new kind of oral hypoglycemic drugs, can significantly lower blood glu-cose levels in the patients with type 2 diabetes without common side effects such as body weight gain, hypoglycemia and gastrointestinal disturbances. Therefore, DPP-4 inhibitors play an increasingly important role in the treatment of type 2 diabetes. In this review, the re-search progress in the action mechanism, pharmacokinetics and clinical applications of DPP-4 inhibitors was summarized in order to provide reference for the clinical application.

BACKGROUND:The finite element model has been developed from two-dimensional model to three-dimensional model, from linear model to nonlinear model. As the advantage of this method in the analysis of mechanical characteristics of the irregular objects, the finite element model has been widely used in the research of orthopedic biomechanics, especial y in the research of hip joint. OBJECTIVE:To analyze the stress state of human femur with finite element analysis method and to investigate a method that can rapidly construct femoral finite element model and precisely analyze the biomechanics. METHODS:Normal male femur was used as specimen for CT scan to obtain cross-sectional images of femur in each slice. Three-dimensional reconstruction was performed with DICOM data and MIMICS software, then the femoral three-dimensional finite element model was established with the finite element analysis ABQUS 6.8 software, and the stress distribution of the model was analyzed under loading condition. RESULTS AND CONCLUSION:Based on DICOM data, three-dimensional finite element model of femur was constructed more quickly and precisely. The models were divided into 38 636 nodes and 201 422 units. The model included the parts of cortical and cancel ous bone. The biomechanical test results were accorded with the previous results, so the model could objectively reflect the real femur shape and biomechanical behavior with high precision. The Mimics software provided a simpler and effective method for the construction of femur model and improved the efficiency of modeling, and the three-dimensional finite element model based on DICOM data was accurate in shape and can be used for the normal research on biomechanical behavior of femur. The stress distribution analyzed with ABQUS 6.8 software is consistent with the clinical observation.

Objective To evaluate the efficacy of ambroxol on community acquired pneumonia (CAP) in elderly patients.Methods Totally 120 patients with CAP were selected and divided into 3 groups:low-dose group (patients received ambroxol 15 mg intravenously,3 times per day,n=40),conventional-dose group (patients received ambroxol 30 mg intravenously,3 times per day,n=40)and control group (patients received routine treatment including antibiotic therapy and oxygen inhalation,n=40).All patients were treated for 7 days.The levels of white blood cell (WBC),high sensitivity C-reactive protein (hs-CRP) and procalcitonin (PCT) were determined dynamically during the treatment.Results The markedly efficient rate,efficient rate and inefficient rate were 62.5％ (25/40),15.0％ (6/40) and 22.5％ (9/40) in low-dose group,82.5％ (33/40),15.0％ (6/40) and 2.5％ (1/40) in conventional-dose group,40％ (16/40),15.0％ (6/40) and 45.0％ (18/40) in control group,respectively.The total efficient rates were 77.5％,97.5％ and 55.0％ in low dose,conventional dose and control groups,respectively.The markedly efficient rate was higher in lowdose,conventional-dose groups than in control group (x2 =15.29,P＜0.05).There was a significant difference in markedly efficient rate between low dose and conventional-dose groups (x2 =4.01,P＜ 0.05).The total efficient rate was higher in low-dose,conventional-dose groups than in control group (x2 20.22,P＜0.05).There was a significant difference in total efficient rate between low dose and conventional-dose groups (x2=7.31,P＜0.05).Compared with before treatment,the levels of WBC,hs CRP and PCT were decreased in 3 groups after treatment (all P＜0.05).The levels of WBC,hsCRP and PCT were decreased more remarkably in low dose,conventional-dose groups than in control group (all P＜0.05).There was a significant difference in the decrease of WBC,hs-CRP and PCT levels between low-dose and conventional-dose groups (all P＜0.05).Conclusions Conventional dose ambroxol treatment (30 mg,iv,3 times/d) is an efficient therapy for community acquired pneumonia in elderly patients.

Pancreatic cancer is one of the most lethal human malignant tumors, and its incidence is rising. Now, its treatment includes surgical resection,chemo - radiotherapy and supplementary treatment. The prognosis of pan-creatic cancer is still dismal. And its one-year survival is low. This article talks about the effect of clinical treatment on quality of life in patients with pancreatic cancer.

Adult ; Aged ; Arthritis, Rheumatoid ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy

OBJECTIVE： To discuss the severe liver function damage induced by antituberculostics.METHODS： The severe liver function damage induced by antituberculotis was analyzed in 50 patients admitted into this hospital from January 1995 to January 2000.RESULTS： Sever liver function damage was related to the following factors:(1)history of liver diseases;(2)aged patient and malnutritional patient;(3)chronic alcoholism;(4)combined use of isoniazid,rifampin with other drugs;(5)hepatic dysfunction before treatment.CONCLUSION： The abovementioned factors should be under consideration in choice of antituberculotics.

Objective To visualize blood flow changes in verruca vulgaris noninvasively with laser speckle contrast analysis (LSCA), and to evaluate the relationship of size and location of warts with efficacy of laser treatment. Methods Pulsed dye laser(PDL)was used to treat 30 verruca vulgaris lesions in 17 patients. In order to evaluate therapeutic effect of PDL, LSCA was performed to observe blood flow in warts and their surrounding normal skin, and to calculate speckle flow index (SFI)values before laser treatment, and at 10 minutes as well as on 3 weeks after laser treatment. Results Before PDL treatment, SFI values were significantly higher in warts than in their surrounding normal skin (11.600 ± 1.190 vs. 5.280 ± 0.481, t = 8.169, P < 0.01). Compared with those before the treatment, SFI values in warts significantly decreased at 10 minutes(3.112 ± 0.484, t = 4.407, P < 0.01)and on week 3(7.315 ± 1.083, t = 3.294, P < 0.01)after the treatment, and were significantly higher on week 3 than at 10 minutes (t = 4.646, P < 0.01). SFI values in surrounding normal skin significantly increased at 10 minutes after the treatment compared with those before the treatment (20.260 ± 2.063 vs. 5.296 ± 0.708, t = 6.770, P < 0.01), but were significantly lower on week 3 than at 10 minutes (4.941 ± 0.616, t = 6.964, P < 0.01). No significant difference was observed between SFI values in surrounding normal skin on week 3 after the treatment and those before the treatment (t = 0.378, P = 0.707). The efficacy of laser treatment was associated wart size and location. Changes of blood flow(|ΔSFI|)were significantly higher in warts measuring less than 0.5 cm2 in size than in those equal to or more than 0.5 cm2 (t = 2.287, P < 0.05), and significantly differed among warts at different sites (F =15.71, P < 0.01). The greatest changes of blood flow in warts were observed on fingers, followed by the dorsum of feet, toes, palms and soles and periungual areas. Conclusions Blood flow in verruca vulgaris is markedly increased compared with that in normal skin. PDL can clear verruca vulgaris by solidifying and gasifying capillaries. LSCA may be used to evaluate the efficacy of laser on verruca vulgaris more quantitively by monitoring regional blood flow.

Objective To review the biologic characteristics and biologic effect of cholecystokinine (CCK) on the central nervous system. Methods The literatures of recent years on research advancement of cholecystokinine as neurotransmitters/peptides in signal transduction, neuron protection and pain management in the central nervous system are reviewed. Results CCK possesses the ability to suppress the convulsant effects of convulsants. CCK8 is able to reduce the neural damage caused and delay the neural aging. CCK antagonists play an important role in human pain transduction. Conclusion CCK has been proven to be one of the richest neurotransmitters/neuropeptides as well as an important signal factor in the brain, and its important biologic effect is being confirmed.

Objective To explore the optimal method of anesthesia in radical resection of gastric cancer by comparing the effects of two anesthesia techniques on the balance of Th1/Th2 in order to provide evidence for clinical anesthesia manage-ment.Methods Forty patients who underwent elective radical resection of gastric cancer were randomized into two groups:in-halation anesthesia group(group S)and total intravenous anesthesia group(group P),in which sevoflurane and propofol were ad-ministered for the induction and maintenance of anesthesia,respectively.The general data of the patients were collected,the tis-sue type of tumors obtained and the fluid infusion and blood loss volumes recoded.The VAS score was obtained 1 h,6 h and 5 d after the surgery.Before the induction of anesthesia,6 h and 5 d after surgery,the blood samples were drawn to determine the serum levels of IL-1β,IFN-γ,TNF-α,IL-2,IL-6 and IL-10.Flow cytometry was used to detect the proportion of CD3+CD8-IFN-γ+ and CD3+CD8-IL-10+ cells and the Th1/Th2 ratio was calculated.Results The level of IL-6 was increased post-sur-gically in groups S and P(P<0.05).There were no significant changes in the levels of IL-1β,IL-2 and IL-10 in groups S and P and in the levels of TNF-αand IFN-γ,and the Th1/Th2 ratio in group S between before the induction of anesthesia and different time points after the surgery(P>0.05).The levels of TNF-αand IFN-γ,and the Th1/Th2 ratio were significantly increased in group P 5 d after the surgery(P<0.05).Conclusion Total intravenous anesthesia with propofol can enhance Th1 response and it is an ideal anesthetic method for radical resection of gastric cancer.

Objective To study the stem development and essential oil distribution in different deve- lopment stages of Pogostemon cablin and to provide theoretical information and practical guidance for reasonable harvest and use of this medicinal plant. Methods Paraffin method, semi-thin sectioning, and histochemical method were used. Results Essential oil was not found in the promeristem of stem; in the primary meristem of stem and the early stage of stem's primary structure, the essential oil was mainly distributed in glandular hairs; in the primary structure of stem, the essential oil was mainly distributed in cortex parenchyma cells; in the secondary structure of stem, the essential oil was mainly distributed in remaining cortex parenchyma cell. Conclusion The essential oil is mainly distributed in the stem bark, so the thickness of a stem bark can be used as a standard of selective breeding index.