Repaglinide is one of the most commonly used oral antidiabetic drugs. It can lower postprandial plasma glucose by means of initiating early-phase insulin release through closing the ATP-dependent potassium channels. Phamacogenomics is a branch of genetics which deals with the genetic variability in individual responses to drugs and drug metabolism. The progress of phamacogenomic study on repaglinide is summarized in this article.

Objective: To investigate the expression of human telomerase reverse transcriptase (hTERT)in benign and malignant gastric diseases and its clinical significance. Methods: The expression of hTERT in 126 gastric tissue specimens obtained by surgery and endoscopy were studied by SP immunohistochemical method. The specimens included 10 cases of nomal mucosa,26 of chronic gastritis, 22 of benign ulcer,5 of leiomyoma, 3 of hyperplastic polyps, 50 of gastric cancer, 2 of maligmant lymphoma and 8 of sarcoma. In precancerous lesions,there was 54 cases of atypical hyperplasia,including 18 low grade, 25 of intermediate and 11 high grade. The positive expression rates and relations of clinical characters were analyzed. Results: hTERT was not or seldom expressed in normal and benign gastric diseases, while it was highly expressed in malignant lesions.There was a significant difference between them(P

Objective To investigate the diagnosis and differential diagnosis of primary hepatic malignant fibrous histiocytoma (MFH) by ultrasound. Methods A retrospective analysis of clinical data and ultrasonic findings was performed on 16 patients with pathologically proven hepatic MFH from July 2005 to August 2012 in Eastern Hepatobilary Surgery Hospital of the Second Military Medical University. Results Of the 16 patients, all the tumors were single, which including 9 tumors located in the right lobe, 6 tumors located in the left lobe, and 1 tumor located in caudate lobe of the liver. The tumor sizes were larger than 10.0 cm in 3 cases, between 5.0 cm and 10.0 cm in 10 cases, and less than 5.0 cm in 3 cases. Tumor internal echo was heterogeneous, including 1 case with honeycomb pattern and 2 cases with mosaic sign. Most tumors were unclearly-deifned (11 cases) without obvious halo. The pathologic results identiifed 15 cases of primary hepatic MFH and 1 case of primary intrahepatic bile duct malignant ifbrous histiocytoma. Conclusions It is dififcult to make correct clinical diagnosis of hepatic MFH. A comprehensive analysis of ultrasound ifndings and clinical information is needed to obtain an accurat diagnosis of malignant liver tumors.

Toll like receptors (TLRs) are the earliest discovered natural immune pattern recognition receptors (PRRs). The abnormality of TLR signal transduction pathway is the key factor leading to chronic inflammatory, cancer, nervous system disease and cardiovascular diseases. The development of TLR agonists and inhibitors has attracted much attention. Currently known TLR2 agonists, such as lipopeptides or their derivatives, have certain limitations in drug development due to their difficult synthesis, easy hydrolysis, and triggering inflammatory cytokine storms, while inhibitors have been rarely reported. New small molecule TLR2 agonists or inhibitors with higher stability are more likely to be developed as tumor immunotherapy or anti-inflammatory drugs.

Objective:To study the indications and clinical efficacy of video assisted small incision in treatment of infected pancreatic necrosis.Methods:A retrospective study was conducted on 27 patients with infected pancreatic necrosis treated by video assisted small incision at the Department of Pancreatic and Splenic Surgery, Hunan Provincial People's Hospital, from January 2018 to December 2019. The surgical approach, operation time, intraoperative blood loss, postoperative hospital stay and complications were analysed. Postoperative follow-up was carried out at outpatients’ clinic, and the patient's time to full recovery and long-term complications were studied.Results:The 27 patients successfully underwent the operations. There were 22 males and 5 females, aged (50.6±6.2) years. The treatment results were analyzed according to the different surgical approaches: the retroperitoneal approach group ( n=4); the omental sac approach group (n=14); the intercostal space approach group ( n=2); and the combined approach group ( n=7). The operation time was (85.3±31.6)min. The intraoperative blood loss was 65.0(45.2, 121.4)ml. The postoperative hospital stay was 23.0(12.5, 36.1)days. The incidence of complications (Clavien-Dindo grade Ⅲ and above) was 14.8%(4/27). There were 2 patients in this study who were admitted to the intensive care unit due to postoperative hemorrhage: 1 patient responded well to conservative treatment and the remaining patient required interventional treatment. Another patient because of poor results, underwent debridement by laparotomy 2 weeks after the operation. There was 1 patient who developed grade C pancreatic fistula which was cured by surgical treatment 6 months later. On follow-up, 2 patients developed colonic fistula 2 weeks after surgery and 2 patients gastric fistula 1 week and 3 weeks after surgery. These patients responded to conservative treatment. Conclusion:With proper case selection, video assisted small incision could safely and effectively be used to treat infected pancreatic necrosis.

Objectives:To compare the effect of glial cell line-derived neurotrophic factor(GDNF) and methylprednisolone(MP) on intracellular free calcium(［Ca2+］i) and capacity of containing water(CCW) after spinal cord injury(SCI).　Methods:Forty-two SD rats were divided into four groups： control, GDNF,MP and GDNF+MP.GDNF and MP were supplied through subarachnoid cavity, tail vein and both of the above after T12 segments spinal cord injury by modified Allen crush method. Animals were executed and specimens were collected at 24 h, 72 h and 168 h after SCI.［Ca2+］i and CCW were measured using Fura-2 method.　Results:Both ［Ca2+］i and CCW of injured spinal cord in GDNF,MP, and GDNF+MP groups were lower than that of the control group at 24 h and 72 h after SCI(P<0.01).Levels of ［Ca2+］i and CCW in GDNF group was much higher than that of MP and MP+GDNF groups(P<0.01),but there was no difference between MP group and MP+GDNF group(P>0.05) 24 hours after SCI. Seventy-two hours after SCI,［Ca2+］i in GDNF group was higher than that in MP group, MP group was higher than MP+GDNF group(P<0.05).CCW of GDNF group exceeded that of MP and MP+GDNF group(P<0.01).［Ca2+］i in GDNF group was higher than that in MP group, and MP group was higher than MP+GDNF group(P<0.01) 7 days postoperatively, but for CCW, there were no differences among GDNF,MP and MP+GDNF groups(P>0.05).　Conclusions: Both GDNF,MP and GDNF + MP groups might reduce ［Ca2+］i and CCW of injured spinal cord. The curative effect of MP for SCI preponderate over that of GDNF, the effect of MP could be enhanced by adding GDNF.

ObjectiveThis paper reported our experience with thoracoscopic management of isolated atrial fibrillation to define the efficacy and safety of this approach.MethodsThirtytwo patients ( 17 mem,15 women) with isolated atrial fibrillation underwent thoracoscopic surgery.All procedures were finished under 3 port incisions on left posterior chest.Among them 18 cases are paroxysmal and 8 persistent.ResultsThere was no operative death or major perioperative complications.One case was converted to limited thoracotomy because of bleeding.Operation time was 87 - 238 min.Paroxysmal atrial fibrillation occurred in 9 cases in hospital and all the cases were sinus rhythm after discharge.Followup 4 to 20 months,One persistent case was converted paroxysmal.ConclusionPatients with isolated atrial fibrillation can benefited by Videoassisted thoracoscopic left posterior approach with better exposure of left atrial and resection of the left atrial appendage,with decreased operative trauma and better results.

OBJECTIVE:To provide reference for the sustainable development of pharmaceutical enterprises in Guizhou prov-ince. METHODS:A questionnaire was conducted for 55 pharmaceutical enterprises in Guizhou province,the basic situation of en-terprises,familiarity of related directors to Good Manufacture Practice of Drugs(GMP)and relevant policy,the current situation of implementing the new version GMP were investigated and statistically analyzed,problems were found,and corresponding coun-termeasures were put forward. RESULTS & CONCLUSIONS:Totally 55 questionnaires were sent out,49 valid ones were received with effectively recovery of 85.1%. The results showed 43 enterprises(87.8%)had passed the GMP authentication;only 13 enter-prises(26.5%)directors were very familiar with the new version GMP. In terms of personnel management,the head of production management and quality management and the authorized person of quality and personnel had not yet met related requirements of the new version GMP fully;in terms of equipment and production management,production area transformation(clean areas,lounges, warehouses,water use) and air purification system design in most enterprises met related requirements of the new version GMP, 23 enterprises (46.9%) still can not conduct fully inspection to products and materials;in terms of document management,there were still some enterprises not meeting the new version GMP standards fully,enterprises'documents(health area layout,air purifi-cation layout,management procedures,operating procedures,etc.) of production site were imperfect. According to the investiga-tion,the main existing problems included lack of funds in implementing the new version GMP reform,not enough understanding or familiarity with the new version GMP,relevant personnel management not reaching the designated position,equipment and pro-duction management needing to be strengthened,document management systemic being poor,risk management being not sound, etc. It is suggested that government should give all forms of capital policy and strengthen the training of the new version GMP;en-terprises should attach great importance to the relevant personnel management,strengthen the equipment and production manage-ment,set up perfect document management system and a sound system of risk management.

Objective To study the therapeutic value of endoscopy for secondary prophylaxis of esophagogastricvariceal bleeding(EGVB).Methods Records of 117 patients with EGVB who were treated with endoscopic ligation and/or histoacryl injection (n =55) and devascularization (n =62) from August 2006 to September 2014 were reviewed.Rebleeding rate,time of rebleeding,incidence of complication,cumulative survival rate,length of ward stay and mean total costs were compared between two groups.Indices were compared according to Child-Pugh.Results The rebleeding rate in the endoscopic group was higher than that in the surgical group[46.2％(24/52) VS 25.0％(15/60),P=0.019] during a mean follow-up of 32.5 months,especially in Child-Pugh B[60.0％(15/25) VS 22.2％(6/27),P=0.006].But the rebleeding time was similar between two groups(P＞0.05).The rate of complications in endoscopic group was lower than that in surgical group [20.0％ (11/55) VS 32.3％ (20/62),P =0.134].No significant difference in cumulative survival rate was observed between the groups (89.1％ VS 87.1％,P＞0.05).The length of ward stay[(14±9)d VS(23±8) d,P＜0.001] and mean total cost[(54 136.79± 44 836.32) yuan VS (73 601.86± 103 403.74)yuan,P＜0.05] in endoscopic group were significantly less than those in surgical group.Conclusion Therapeutic endoscopy is as effective as secondary prophylaxis of esophagogastric variceal bleeding.Endoscopic treatment leads to higher rebleeding rate,but is advantageous in similar rebleeding time,smaller injury,less complications,shorter length of ward stay and lower costs.

Objective To observe the effects of butylphthalide on the expression of autophagy-related protein and mRNA in l-meth-yl-4-phenyl-pyridiniumion (MPP+)-induced SH-SY5Y cells, and to explore the protective effect and possible mechanism of butylphthalide to the cell model of Parkinson's disease. Methods The SH-SY5Y cells were divided into control group (A), MPP+group (B), rapamycin pre-treated+MPP+group (C) and Butylphthalide pretreated+MPP+group (D). The relative viability of SH-SY5Y cells induced by MPP+was measured with MTT assay, the morphology of SH-SY5Y cells was observed. The expression of microtubule associated protein 1 light chain 3 (LC3)-II/I and Beclin 1 protein was detected by Western blotting. And the expression of LC3-II/I and Beclin 1 mRNA were assayed by re-al-time quantitative reverse transcription-PCR (RT-PCR). Results The viability rates of cells were significantly lower in group B than in group A (t=20.270, P<0.001), and were significantly higher in groups C and D than in group B (t>8.770, P<0.001), however, there was no significantly difference between groups C and D (t=2.270, P=0.064). The expression of LC3-II/I and Beclin 1 was higher in group B than in group A (t>6.647, P<0.01), and was higher in groups C and D than in group B (t>3.630, P<0.01), however, there was no significantly differ-ence between groups C and D (t<2.238, P≥0.05). Conclusion Butylphthalide could prevent the injury of SH-SY5Y cells induced by MPP+, which may affect Parkinson's disease by inducing autophagy.