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

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 .

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.

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 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.

The nerve tissue engineering is to apply scalfolds and seed cells for the treatment of injury or disease of nerve system by restoring their anatomic structures and funetiorm.The scaffolds played important roles in supporting and conducting axonal regeneration.They could also limit the in-growth of scar tissue and hence help to build the connection between axonal and target cell.Self-assembling peptide scaffold is one of the excellent material used is nerve tissue engineering.This article reviews the self-assembling peptide based scaffolds for nerve tissue engineering and discusses the unsolved problems in the fields and the trend d the related research in the future.

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.

Dyslipoproteinemia is correlated with the occurrence and development of atherosclerosis and cardiocerebral vascular diseases. The metabolism of serum lipoprotein, however, is a complicated and ordered metabolic process. On one hand, every organ, tissue and even cell of the body participates in and affects the state of serum lipoprotein dynamic balance (SLDB) in different degrees. On the other hand, SLDB is a direct factor for maintaining the normality of whole vascular system, especially the vascular endothelium system. The serum lipoprotein dynamic imbalance, as an inducement or even etiological factor, can bring about various clinical diseases. Therefore, integrated analysis is needed to appropriately assess the state of SLDB. It is suggested that serum lipoprotein dynamic imbalance syndrome should be the key risk factor for those related diseases. Serum lipoprotein electrophoretogram can ideally express the state of SLDB and be taken as a new index for cognizing the serum lipid metabolism and the function of speen-qi to distribute Jing (Essonse) in the integrated traditional Chinese and western medicine. Practice has showed that concrete integration and bilateral development should be one of the main tasks in current researches of integrated traditional Chinese and western medicine.

Objective To investigate the effect of Zhibaidihuangwan combined with clindamycin hydrochloride on serum IL-8, TNF-α, IL-10 levels in periodontitis and its clinical efficacy.Methods A total of 98 patients with periodontitis from our hospital were collected and randomly divided into the control group and the experimental group, 49 cases each group.Patients in the control group were treated on the basis of the foundation therapy with clindamycin hydrochloride, patients in the experimental group were treated with Zhibaidihuangwan on the basis of control group .The periodontal pocket depth, plaque index, gingival index and positive rate of probe bleeding, serum IL-8, TNF-a, IL-10 levels were measured, and the clinical efficacy were compared.Results The effective rate of the experimental group(93.88%) was higher than the control group(79.59%), with statistical significance (P<0.05).The positive rate of probe bleeding in experimental group (38.78%) was lower than control group of two groups(59.18%), with statistical significance (P<0.05).The periodontal pocket depth, plaque index, gingival index in experimental group were lower than the control group after treatment, the TNF-αand IL-8 levels in experimental group were lower than the control group, IL-10 was higher than the control group after treatment, with statistical significance (P<0.05).Conclusion Zhibaidihuangwan combined with clindamycin hydrochloride could reduce periodontitis serum IL-8 and TNF-αlevels, improve the level of IL-10.