Objective To investigate the effects of Metformin on serum proprotein convertase subtilisin/kexin type 9(PCSK9)level in patients with type 2 diabetes(T2DM). Methods 48 healthy people with normal glucose tolerance were selected as the controls (NGT group). 93 newly diagnosed T2DM were randomized to Metformin treated group (Met,n= 47 )and Glipizide treated group (Gli,n=46).Serum PCSK9 was measured by ELISA in all participants. After treatment,the changes of serum PCSK9 were observed in Met group and Gli group. Results Serum PCSK9 levels in Met group and Gli group were higher than NGT group(P<0. 01). PCSK9 level was positively correlated with FPG,HbA1 c, HOMA-IR,FIns,TC,LDL-C,TG,hsC-RP,TNF-αand BMI (r= 0. 578,0. 638,0. 556,0. 610,0. 578, 0. 592,0. 589,0. 638,0. 561,0. 552;P<0. 05 or P<0. 01),and negatively correlated with HDL-C(r=-0. 614,P<0. 01). The levels of PCSK9 significantly decreased after treatment with Metformin(P<0. 05). PCSK9 levels had no significant differences before and after treatment with Glipizide. Multiple regression analysis showed that TNF-αand HOMA-IR were independent related factors of PCSK9. Conclusion T2DM patients have high levels of serum PCSK9 which can be decreased by Metformin.

Adolescent ; Adult ; Child ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; Musculoskeletal Manipulations ; Snoring ; therapy ; Young Adult

Objective To study the changes of serum albumin and its relationship with B-Type Natriuretic Peptide(BNP),High sensitivity C-reactive protein(hs-CRP)and left ventricular ejection fraction (LVEF) in patients with acute myocardial infarction(AMI).Methods Serum levels of albumin,BNP,hs-CRP at baseline were analyzed in 95 patients with AMI,and LVEF were measured by echocardiography.All AMI patients were divided into 2 groups based on the values of serum albumin:the hypoalbuminemia group and the normal albuminemia group.Fifty patients without coronary artery disease were selected as controls.The correlations between serum albumin and BNP,hs-CRP,LVEF were analyzed.Results Serum albumin in AMI patients was lower than that in the controls[(38.45±4.60) g/L vs.(43.15±3.11) g/L ;t =8.53,P ＜ 0.001].BNP and hs-CRP levels in the hypoalbuminemia group were higher than that in the normal albuminemia group [(5.24±1.71)ng/L vs.(4.17±1.61) ng/L;t =2.660,P =0.009;(1.64±0.93) mg/L vs.(1.13±1.03)mg/L;t =2.159,P =0.045].LVEF in hypoalbuminemia group was lower than that in the normal albuminemia group[(49.10±11.63) ％ vs.(54.63±9.60) ％ ; t =2.268,P =0.025].Levels of serum albumin were negatively correlated with BNP and hs-CRP in AMI patients(r =-0.465,P ＜0.001 ; r =-0.391,P ＜ 0.001).Levels of BNP were positively correlated with hs-CRP(r =0.492,P ＜ 0.001).LVEF was negatively correlated with BNP values(r =-0.371,P ＜ 0.001).Conclusion Hypoalbuminemia is associated with the prognosis of AMI and may be an important predictor of adverse outcome in patients with it.

AIM: To evaluate the safety and effectiveness of 23G and 20G vitreous cutting system in silicone oil extracting operation.
●METHODS:A total of 98 cases (98 eyes) patients, after 3- 6mo silicone oil filling with retinal attachment and suitable for retrieving silicone oil. Patients were randomly divided into two groups. 20G vitreous cutting system group including 48 cases ( 48 eyes ) and 23G vitreous cutting system group including 50 cases ( 50 eyes ) . A series of comparative analyses were conducted on the times for set up and closing the passage and the time for taking the oil time on the two groups:intraocular pressure of preoperative and of postoperative for 1, 3d, 1wk, 3 and 6mo. The comparisons were also made between the best corrected visual acuity of preoperative and postoperative. The section inflammation of postoperative 1, 3d, 1mo were compared. Complications were compared between intraoperative and postoperative.
●RESULTS:Establishing surgery channel for 20G and 23G group were ( 243. 54 ± 51. 17 ) s and ( 91. 16 ± 21. 37 ) s respectively;closing wound time were (235. 04 ± 42. 89) s and (86. 04±21. 76)s. Extracting oil time were (6. 7±1. 65) min and ( 7. 35 ± 2. 02 ) min. There was a significant difference ( P<0. 01 ) between establishing the operation channel time and close the incision time. There was no significant difference between two groups in the extracting oil time (P>0. 05). The first day was statistically different ( P< 0. 05 ) but the rest of the time point of intraocular pressure had no statistical difference ( P >0. 05). The best corrected visual acuity for 20G and 23G group preoperative and postoperative after 6mo were:4. 21 ± 0. 61, 3. 91 ± 0. 64; 4. 03 ± 0. 46 and 4. 22 ± 0. 39 respectively. There was no significant difference between the two groups (P>0. 05). There was significant difference ( P<0. 05) of cells in the anterior chamber between the 20G group and 23G group of postoperative 1 and 3d. There was no statistical difference after 1mo (P>0. 05). The findings also reported that 20G and 23G group had no intraoperative complications and postoperative. For 23G group, 5 cases of temporarily had lower intraocular pressure, 1 case was retinal again, 1 case was choroid detachment. For 20G group, 1 case of temporarily had lower intraocular pressure, 3 cases were retinal detachment and 2 cases were choroid detachment.
●CONCLUSION:23G vitreous cutting system has the advantages of low operation steps, intraoperative injury. The postoperative complications of low probability, used in silicone oil is safe and effective.

Interleukin-10 (IL-10) is an immuno-regulatory cytokine,which is well known for its immunosuppressive function.IL-1O can act on a variety of immune cell subsets and play an immunosuppressive effect through a variety of ways.It plays an important role in the tumor immune escape.Recent studies show that IL-10 also has an immune-stimulating function,which is presumably a pluripotent cytokine.This paper will combine the latest literature to summary the positive and negative regulatory roles of IL-10,mediation ways in the tumor and the relationships with prognosis.

Aim To develop a model for screening DPPIV inhibitor from Chinese Herbal medicine.Methods With Gly-Pro-PNA as a substrate,DPPIV activity was assayed by the chromogenic substrate.The concentration of DPPIV and Gly-Pro-PNA,temperature,pH and reaction time were optimized.Results The optimal enzymatic reaction system was as follows:DPPIV 0.5 U?L-1,Gly-Pro-PNA 0.262 ?mol?L-1,37℃,pH 8.2,reaction for 60 min.Further more,many kinds of herbal abstracts were screened and some had the DPPIV inhibitory function,such as Leech,Poria cum Radix Pini and Buddleja officinalis Maxim.Conclusion The model can be used to screen for DPPIV inhibitors in vitro.

Cicatrix ; therapy ; Humans ; Laryngeal Diseases ; diagnosis ; therapy ; Vocal Cords ; pathology ; physiopathology

Objective]Training students to consult literature, teamwork, language expression, report writing and other aspects of the ability to develop professionalism, improve the overall quality.[Methods] We review reflections of the current situation on teachingChinese Medical Historycurriculum, put forward a set of time as the main line, physicians investigating and studying as the center, set questionnaires, group discussions, class reporting, comprehensive evaluation of integrated interactive solutions.[Results] By strengthening the self-study and discussion, to stimulate students' enthusiasm for learning and exploration, so that students master the initial medical history of the life, works and academic achievements, for the future in-depth study of traditional Chinese medicine professional knowledge and lay a good foundation. [Conclusion] After preliminary practice, it achieved good results, to be promoted in Tianjin University of Traditional Chinese Medicine.

Dysregulation of cell metabolism, especially glucose metabolism, is implicated in tumorigenesis and tumor progression.Cancer cells uptake a large amount of glucose and prefer to perform glycolysis in the cytosol even under normal oxygen condition, which fuels fast cell growth and proliferation.Dysregulation of glucose metabolism leads to tumorigenesis and promotes cancer development.Conversely, the initiation and development of cancer reprograms glucose metabolism to confer cancer cells the ability to survive and proliferate.Oncogenes, tumor suppressors or non-coding RNAs could regulate glucose metabolism.Meanwhile, the enzymes and metabolites involved in glucose metabolism could regulate the expression of factors related to cancer.Enzymes, the direct executor of cell metabolism, play a key role in dysregulation of glucose metabolism, tumorigenesis and tumor development.

In order to realize the seamless connection between superior and inferior medical institutions and simplify the process of patient referral to superior medical hospitals from the community medical institutions,Zhenjiang First People's Hospital designs a two-way referral platform for direct registration to Zhenjiang First People’s Hospital from community medical institutions.The paper introduces the design process,features and realization steps of this platform.The platform can realize the sharing of patient information between the community medical institutions and the hospital,facilitate patients' seeing a doctor and improve medical service level.