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 expression of type Ⅰtransforming growth factor ?(T?R-Ⅰ)in renal cortex in streptozotocin-induced type Ⅱ diabetic mellitus and the regulation of valsartan. METHODS: The rat models of type Ⅱ diabetic rats were made. At the end of the 20th weeks,the kidneys were taken out to measure the expression of T?R-ⅠmRNA by RT-PCR. RESULTS: The expression of T?R-ⅠmRNA in diabetic rats without any therapy ( 0.72? 0.14) was higher than that in control ( 0.26? 0.12) (P

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 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.

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 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.

Objective To explore the biological characteristics of mucinous adenocarcinoma deriving from chronic anal fistula and its diagnosis and treatment. Method A retrospective study was made to analyze clinical and pathological features of 4 cases of chronic anal fistula from which mucinous adenocarcinoma developed in our hospital from 1986 to 1997. Results There were three males and one female averaging 50 years old. All patients had chronic history of perianus abscess or anal fistula. This rare mucinous adenocarcinoma originated from the anal fistula and the associated anal glands. The canceration of anal fistula was due to chronic inflammation and scarring. The definitive diagnosis of the carcinoma depends on biopsy of the fistula and the related tumor. Metastasis to groin lymph nodes was found in two patients. Three cases underwent Miles operation with chemotherapy; two of the three patients also had resection of groin lymph nodes. Three patients survived more than five years. One patient treated only with chemotherapy died three months later. [WT5”HZ] Conclusion [WT5”BZ] Mucinous adenocarcinoma following chronic anal fistula is less malignant and has better prognosis compared to primary rectal and anal mucinous adenocarcinoma.

AIM: To investigate the role of proliferation and apoptosis in hypertensive left ventricular hypertrophy (LVH) and the effect of AT 1 blockade with losartan. METHODS: Left ventricles (LV) from 12, 24-week-old SHR (SHR 12 , SHR 24 ), 24-week-old SHR treated with losartan (15 mg?kg -1 ?d -1 , SHR-L 24 ) during 12 weeks, and age-matched WKY rats (WKY 12 , WKY 24 ) were studied. Expression of PCNA was examined by immunohistochemistry. Apoptotic cells in LV sections were assessed by TUNEL method. Levels of fas mRNA were quantitated by RT-PCR. RESULTS: Compared with age-matched WKY, SHR 12 and SHR 24 showed increased LV hypertrophied index (HI), increased apoptotic index (AI) of myocytes ( P