Objective To observe the efficacy and safety of pigolitazone/metformin fixed-dose combination therapy replacing metformin alone or combined with other anti-diabetes drugs in type 2 diabetes with poor glycemic control.Methods 80 cases were recruited,with an average age of (54.79±13.99)years,diabetes history of (9.76±6.59) and baseline HbA1c (9.06±1.34)％.All participants received pigolitazone/metformin instead of metformin without other treatment changes.Glycemic control (level of fast blood glucose,HbA1c) was evaluated at 12 weeks,as well as lipid profiles,liver and renal function,adverse events and body weight.Results 8 cases were lost to visit,4 cases were withdrawn for edema,only 68 subjects finished the study.Compared to the baseline,after 12-week treatment,FPG decreased for (2.06+0.16) mmol/L,HbA1c decreased for (0.84+0.23)％,both of the differences were statistically significant (P＜0.001,P＜0.001).Body weight increased (0.34+1.13)kg,with no difference compared to the baseline.The lipid profile presented elevated high density lipoprotein cholesterol (P=0.012)and decreased total cholesterol,low density lipoprotein cholesterol,triglyceride,while the latter three items showed no differences (P＞0.05,P＞0.05,P＞0.05).Indexes reflecting liver and renal function,such as ALT,AST,TBIL,DBIL,Urea,UA,Cr showed no differences compared with the baseline.Adverse events analysis showed at the end of the study,no severe hypoglycemia and serious cardiovascular events occurred,6 cases suffered edema,among whom 4 patients exited the study for severe lower limb edema.No extra gastrointestinal symptom happened.Conclusion Pigolitazone/metformin fixed-dose combination exhibits an excellent efficacy and safety for T2DM,with satisfying tolerability and compliance,which is a selection for those patients with poor glycemic control.

Objective To compare the therapeutic effect of postprandial and preprandial injection of glulisine.Methods Sixty hospitalized patients with T2DM receiving one dose of glargine and three doses of glulisine were recruited.They were randomly divided into two groups:group A and group B when the glycemic state and insulin dosages had been stable for more than seven days.Two-stage cross design:stage 1:group A (n=30):glulisine was injected before meal;Group B (n=30):glulisine was injected after meal.Blood glucose was monitored for three days.Stage 2:glulisine was injected after meal in group A while before meal in group B without dosages adjustment,and blood glucose was monitored continuously for three days.Then standard deviation of blood sugar (SDBG),blood glucose fluctuation after meal (PPGE),maximum blood glucose fluctuation range (LAGE) during 24 hour and satisfaction values of insulin treatment (SVIT) were compared.Results There was no significant differences between group A and group B in terms of age((50.70±13.29)years vs (55.63±13.05) years,P=0.152),diabetes course((36.23±29.20)months vs (43.63±32.19) months,P=0.355),HbA1c ((10.05％± 1.46％)vs (9.81％±2.08％,P=0.612),daily insulin dose((35.67±8.64)U vs (34.83±8.24) U,P=0.704),SDBG ((2.63±0.58 vs (2.84±0.64)) before operation.There was no significant differences of SDBG(F=0.432,P=0.73),PPGE (F=1.216,P=0.31),LAGE (F=0.431,P=0.73) or SVIT (F=0.685,P=0.56) between glulisine injected before and after meal.Conclusion Postprandial glulisine administration can provide the same effect in lowering glucose,satisfaction values and reducing glucose fluctuation as preprandial injection.

Objective To explore the feasibility and application value of sonography in the evaluation of oropharynx in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods The oropharynx of forty-four patients with OSAHS and forty-four healthy subjects selected as the control group were separately examined by ultrasonography.The parameters including anterior-posterior diameter and the lateral diameter of oropharyngeal airway of the end-deep inspiratory and end-deep expiratory,thickness and wide of tongue base,lingual wide,lingual height,distance from mandibular plane to hyoid bone and distance from tongue base to mandibular plane were obtained for statistical analysis and compared between the two groups.Correlation analysis of above parameters plane with body mass index (BMI) were carried out. Results The anatomy of the oropharynx was well shown on sonography.When compared with the control group,the lateral diameter of oropharyngeal airway,thickness of tongue base,lingual height,lingual wide and distance from mandibular plane to hyoid bone also showed significant statistically differences between the OSAHS patients group and the control group (all P <0.01).The wide of tongue base,thickness of tongue base,lingual wide,lingual height,distance from mandibular plane to hyoid bone,and distance from tongue base to mandibular plane in OSAHS patients group were positively correlated with BMI( r =0.533,0.415, 0.555,0.349,0.378,0.419;all P <0.05).The wide of tongue base and lateral diameter of oropharyngeal airway in the control group were negatively correlated with BMI ( r = -0.324,-0.405,-0.317;all P <0.05).Conclusions Ultrasonography can be used to assist in the assessment of OSAHS,which can provide an important reference for clinical diagnosis and therapeutic effect evaluation of OSAHS.

CX3CL1, also known as Fractalkine, is the only member of chemokines CX3C subclass. It plays an important role in a variety of central nervous system diseases and ischemic cerebrovascular diseases by binding to its specific receptor CX3CR1. In recent years, a large number of studies have investigated the specific role and related molecular mechanism of CX3CL1/CX3CR1. This article reviews the effect and molecular mechanism of CX3CL1/CX3CR1 in ischemic cerebrovascular disease, aiming to expand the understanding of the mechanism of CX3CL1/CX3CR1, and provide new ideas and intervention targets for the prevention, diagnosis and treatment of ischemic cerebrovascular disease.

BACKGROUND:Cervical rotation-traction manipulation is effective and safe in the treatment of cervical spondylotic radiculopathy,and has been widely used in clinical work.However,its effects on the biomechanics of cervical vertebra and intervertebral disc and the area of intervertebral foramen have not been systematically clarified. OBJECTIVE:Based on the finite element analysis technique,a relevant research and analysis were carried out to provide digital evidence for the mechanism of effect of cervical rotation-traction manipulation in the treatment of cervical spondylotic radiculopathy. METHODS:The CT image data of a volunteer with no neck diseases were selected as the finite element model material at its left-handed physiological limit position.The initial construction of the finite element model was completed by Mimics 19.0 software,Geomagic Studio 2013 software,Hypermash 14.0 software,and ANSYS Workbench 2020 R2 software,respectively.Based on the literature,the grid division of cervical structure and the assignment of elastic modulus and elastic coefficient were completed.Based on the previous work of the team,the mechanical effects of cervical rotation-traction manipulation were simulated on the model.Effects of cervical rotation-traction manipulation on the mechanical parameters of each vertebral body and intervertebral disc in C3-T1 segment and on the cervical lateral foramen area were analyzed. RESULTS AND CONCLUSION:(1)During cervical rotation-traction manipulation,the stress of bone structure was significantly higher than that of soft tissue such as intervertebral disc.(2)When operating the technique,the stress at the top of each cervical vertebra was higher,the stress at the bottom was lower,and the stress at the facet joint and transverse process was lower.The stress at the top of the intervertebral disc was lower,the stress at the bottom was higher,but the highest point of the intervertebral disc stress was outside the top.(3)In addition,after loading the lifting force,the projected area of the C6/C7 intervertebral foramen increased significantly compared with that before loading.(4)It is indicated that the cervical rotation-traction manipulation has the mechanical characteristics of changing the stress structure of the cervical spine itself,and can expand the C6/7 intervertebral cervical foramen area on the opposite side of the patient's cervical rotation,so as to achieve the purpose of treating cervical spondylotic radiculopathy.

Objective To investigate the role of miR-194-3p in regulating functional changes in osteoblasts in a simulated microgravity environment and to provide a theoretical foundation for understanding the mechanical response mechanisms of osteoblasts in extreme mechanical environments.Methods The effects of microgravity on osteoblasts were simulated by using a rotary cell culture system.MC3T3-E1 osteoblasts were transfected with an miR-194-3p inhibitor and changes in proliferation,differentiation,apoptosis,and mineralization were assessed using MTT assay,RT-PCR,Western blot,double fluorescence staining,and alizarin red staining.Results Elevated expression of miR-194-3p under simulated microgravity conditions led to the suppression of osteoblast proliferation,differentiation,and mineralization to a certain extent,while promoting osteoblast apoptosis.However,transfection with the miR-194-3p inhibitor significantly downregulated miR-194-3p expression and partially reversed the reduced osteoblast proliferation,decreased expression of osteogenic differentiation markers such as ALP,OCN,and COL-I genes and proteins,decreased bone mineralization nodules,and increased osteoblast apoptosis induced by microgravity exposure.These findings indicated that miR-194-3p effectively ameliorates abnormal osteoblast function under microgravity conditions.Conclusions MiR-194-3p acts as a negative regulatory factor in the mechanical responses of osteoblasts under simulated microgravity.