Objective To discuss the efficacy and safety of sitagliptin combined with metformin in treatment of type 2 diabetes mellitus(T2DM).Methods One hundred patients with T2DM were divided into two groups by random digits table method with 50 cases each.The patients in study group were given phosphate sitagliptin (100 mg,day 1 oral) combined with metformin (500 mg,day 3 oral).The patients in control group were given repaglinide (1 mg,day 3 oral) combined with metformin (500 mg,day 3 oral).They were treated for 12 weeks and fasting plasma glucose(FPG),2 h postprandial blood glucose(2 h PG),glycosylated hemoglobin (HbA1c),fasting insulin (FINS),body mass index (BMI) and the incidence of hypoglycemic events were detected before and after treatment.Results After treatment,the level of FPG,2 h PG,HbA1c was significantly lower than that before treatment in two groups,and there was significant difference (P ＜ 0.01).The level of B MI after treatment was significantly decreased [(24.45 ± 2.13) kg/m2 vs.(25.46 ±2.62) kg/m2] and FINS was significantly increased [(13.36 ± 1.89) mU/L vs.(12.36 ± 1.80)mU/L] compared with that before treatment in study group (P ＜ 0.05 or ＜ 0.01).But the level of BMI and FINS had no significant difference before and after treatment in control group (P＞ 0.05).The incidence of hypoglycemic events had significant difference between study group and control group [0 vs.12％ (6/50)] (P ＜ 0.05).Conclusions Sitagliptin combined with metformin is safe and effective in treatment of type 2 diabetes mellitus,which is the preferred solution treatment.The risk of hypoglycaemia events is obviously reduced,also it can control and reduce weight and other advantages.

Ear, Inner ; surgery ; Humans ; Neuroma, Acoustic ; surgery ; Otologic Surgical Procedures ; methods

0. 05), respectively. Conclusion: Repeated +Gz stress may disorder the ratio of ET and NO. This imbalance may be one of the causes which lead to pathology changes in masseter musscles.

Aim To study the effect of silymarin on proliferation and apoptosis of human osteosarcoma saos-2 cells and to explore its possible mechanisms .Meth-ods Control group and different concentration groups of silymarin were set , and Saos-2 cells were treated with silymarin .Celluar morphologic changes were ob-served by inverted phase contrast microscope .Prolifer-ation of cells was tested CCK-8 assay .Apoptosis rate of cells was analyzed by flow cytometry . ERK1/2、p-ERK1/2 and cleaved caspase-3 protein expression were measured by Western blot .Results Silymarin inhibi-ted the proliferation of Saos-2 cells in a time-dependent and concentration-dependent manner . Silymarin in-duced the apoptosis of Saos-2 cells in a concentration-dependent manner . Silymarin decreased p-ERK1/2 protein expression and increased cleaved caspase-3 protein expression in a concentration-dependent man-ner, while ERK1/2 protein expression had no obvious change.Conculsions Silymarin can inhibit the prolif-eration of human osteosarcoma saos-2 cells and induce apoptosis of them , and the mechanism may be related to inhibition of ERK signaling pathway and upregulated caspase-3 protein expression .

Objective To determine the serum levels of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in patients with systemic lupus erythematosus (SLE) and their clinical significances. Methods The serum concentrations of MMP-9 and TIMP-1 were measured by ELISA in 46 patients with SLE and age- and sex-matched normal controls. Results ①Serum levels of MMP-9 was significantly decreased in patients with SLE compared with those in normal controls (P

Objective To probe into the effect of the enteral nutrition added with lactobacillus on gastric bacteria of rats with severe brain injury. Methods Severe brain injury was made in rats that were then fed with enteral nutrition (3-9 entire nutrients), lactobacillus (3-9 entire nutrients + lactobacillus) and synbiotics (3-9 entire nutrients + lactobacillus + fiber) respectively. Gastric body and gastric antrum mucosa were collected at day 1, 3 and 7 after injury to detect the change of the gastric bacteria. Results DCCE analysis showed less bacteria in sham operation group. On the first day after severe brain injury, the flora bands were increased remarkably but the number of bacteria was decreased in three groups. The similarity of denaturing gradient gel electrophoresis ( DGGE) map patterns was 65% , 64% and 53% respectively in the enteral nutrition group, lactobacillus group and synbiotics group, with no significant difference in regard of the diversity index. On the third day after severe brain injury, the flora bands showed a tendency of decrease, with the similarity of denaturing gradient gel electrophoresis (DGGE) map patterns for 72% , 58% and 62% respectively. The richness and diversity of total bacteria in the lactobacillus group was remarkably lower than that in the enteral nutrition group and synbiotics group (P＜0.01). On the seventh day after SHI, the flora bands were decreased in three groups, with the minimum number of the bacteria. The similarity of denaturing gradient gel electrophoresis ( DGGE) map patterns was 61% , 51% and 58% respectively, with higher richness and diversity of total bacteria in the synbiotics group compared with the other groups. Conclusion Lactobacillus can help improve gastric bacteria disturbance of rats with severe brain injury. In the meantime, addition of the lactobacillus is better than addition of the synbiotics.

Objective To improve the quality of life of the female patient after radical cystectomy. Methods Modified radical cystectomy and detenia cecocolon neobladder were performed in 4 female patients with bladder cancer.Three patients underwent radical cystectomy with preservation of the anterior wall of vagina.One patient underwent radical cystectomy with resection of the anterior wall of vagina. Results The patients were followed-up for 6 to 30 months.All 4 women achieved acceptable daytime continence,and 3 out of 4 achieved nocturnal continence.The vesical capacity ranged from 305 to 438 ml and intravesical pressure at maximum capacity ranged from 18 to 45 cmH 2O(1 cmH 2O=0.098 kPa);only 1 had nocturnal incontinence.The urinary dynamic examination showed the maximum urinary flow rate varied from 15.1 to 22.6 ml/s and residual urine volume ranged from 0 to 30 ml.The cystography showed there was no ureteral stenosis or reflux in the 4 patients.Their renal function and metabolism of electrolytes were normal. Conclusions Detenia cecocolon neobladder after modified radical cystectomy in selected women can obtain satisfactory continence and voiding results.

Objective To develop a more ideal procedure of living donor nephrectomy. Methods Ten cases of living relate donor who received laparoscopic nephrectomy were regularly followed up from 2 to 12 months. Results These donors were discharged on the day 5 after operation. Renal function of the recipients was normal in 4 days after operation. The advantages of laparoscopic living related donor nephrectomy included smaller incisions, less pain, faster recovery and short hospitalization. Conclusion Laparo- scopic living related donor nephrectomy is effective and safe.

The article thinks that the environment of embedded users' clinical scientific research is the key to the subject service.It explains the background and causes of embedded clinical scientific research and analyses the problems exist in subject service of library in hospital.At last,it comes up with some effective measures in solving the subject service of embedded clinical scientific research.

Objective To analyze the change and clinical significance of blood lipid and high sensitive-C reactive protein (hs-CRP) in patients with subclinical hypothyroidism.Methods Fifty patients with subclinical hypothyroidism were selected as observation group,and 50 health people with the same gender and age were selected as control group.The blood lipid and hs-CRP levels in the two groups were measured and compared.Results The total cholesterol (TC),triacylglycerol (TG),and low density lipoprotein cholesterol (LDL-C) in observation group were significantly higher than those in control group [(5.20 ±0.84) mmol/L vs.(4.79 ±0.80) mmol/L,(2.21 ±0.97) mmol/L vs.(1.78 ±0.60) mmol/L,(3.25 ±0.65) mmol/L vs.(2.83 ±0.51) mmol/L],high density lipoprotein cholesterol (HDL-C) was significantly lower than that in control group [(1.18 ± 0.15) mmol/L vs.(1.28± 0.22) mmol/L],and there were statistical differences (P ＜ 0.05 or ＜ 0.01).The hs-CPR in observation group was significantly higher than that in control group [(4.2 ± 1.1) mg/L vs.(3.0 ± 0.8) mg/L],and there was statistical difference (P ＜0.01).Conclusions Subclinical hypothyroidism can cause increased TC,TG,LDL-C and hs-CRP and decreased HDL-C,which may accelerate atherosclerosis and cardiovascular disease.It is necessary to timely screen and treat the disease.