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

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.

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 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.

[Summary] Benign esophageal strictures can arise from various causes and mainly induce dysphagia .Commonly , the majority of benign esophageal strictures can achieve long-term relief through about three dilation sessions .However, some refractory benign esophageal strictures require other treatments , such as endoscopic stent placement and intralesional drug injection , but these treatments just attain short-time satisfactory results with a disappointingly low rate of long-term improvement.Recently, biodegradable stents and drug-eluting stents are developing and have obtained the positive effects .In this paper , we performed a review about the treatment of benign esophageal strictures .

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.

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