Objective To evaluate the value of real time continuous blood glucose monitoring system (RT-CGMS) versus intermittent blood glucose monitoring (IGM) in the critically ill patients under intensive insulin therapy (IIT).Methods A systematic searching randomized and controlled trials (RCT) in databases was performed for meta-analysis by Review Manager 5.2 software.Outcomes were hypoglycemia episode,alteration of mean blood glucose level,the percentage of time at a blood glucose level within optimal target range,and the early mortalities.Results Six studies,totally 531 patients,were included in this meta-analysis.The pooled SMD of mean blood glucose level was =-0.21 (95％ SMD:-0.43-0.01,P=0.07).The pooled SMD of percentage of time at a blood glucose level within optimal target range was 0.20 (95％ SMD:-0.09-0.49,P =0.18).The pooled OR of hypoglycemia episode frequency was 0.20 (95％ CI:0.09-0.43,P ＜ 0.01).The pooled OR of early mortalities was 0.35 (95％ CI:0.14-0.89,P =O.03).Conclusions In critically ill patients under the intensive insulin therapy,RT-CGMS had obvious beneficial effect on reducing hypoglycemic events.RT-CGMS had no obvious beneficial effect on keeping blood glucose level within optimal target range.

BACKGROUND:The precise pathogenesis of recurrent aphthous ulcers remains controversial in present medical science. Oxygen free radical increase in the body is one of the causes of recurrent aphthous ulcers. OBJECTIVE:To observe the effects of superoxide dismutase on the therapeutic effect of recurrent aphthous ulcers. METHODS:After establishing 24 rabbit models of recurrent aphthous ulcers, they were randomly assigned to three groups. Model control group as a contrast was not treated. Rabbits in the negative control group were cleaned with iodoglycerin in local region daily. Rabbits in the superoxide dismutase group were intragastricaly administered with superoxide dismutase capsule solution. Local ulcer was cleaned with iodoglycerin. One week later, tissue with oral ulcer lesions was obtained and compared. In each group, after model establishment, blood was colected from rabbit ear vein at the same time in the morning every 4 days. Flow cytometry was used to analyze the changes in T cel subsets CD3+, CD4+, CD8+, and CD3+/CD8+. RESULTS AND CONCLUSION: When the ulcer lesions formed, peripheral blood CD3+, CD4+, CD4+/CD8+ ratio through statistics was apparently lower than normal levels in the model control group and negative control group. However, the number of CD8+ cels was greatly more than normal value. In the superoxide dismutase group, after administrated with superoxide dismutase capsule, the number of CD3+ and CD4+ cels was gradualy increased, but the number of CD8+ cels showed a decreased trend. These data suggested that natural scavenger superoxide dismutase using oxygen free radical can effectively scavenge excessive oxygen free radical in the ulcers, resulting in treatment of recurrent aphthous ulcers.

Objective To study the efficacy of disodium pamidronate in the treatment of patients with primary hyperparathyroidism (PHPT) complicated by hypercalcemic crisis.Methods A total of 9 patients (12 cases) admitted into our hospital were diagnosed as PHPT complicated by hypercalcemic crisis.Of them,4 patients had parathyroid carcinoma,3 patients had parathyroid adenoma,2 patients had parathyroid hyperplasia.The intravenous disodium pamidronate was given for 12 times in all 9 patients.Serum calcium were monitored before and after treatment.Results Before the treatment,the serum calcium levels was 3.75 (3.66,3.99) mmol/L.On the second and third day after the treatment with disodium pamidronate,the serum calcium levels were 3.44 (2.95,3.78) mmol/L and 2.79 (2.50,3.14) mmol/L.The lowest level of serum calcium after treatment was 2.25 (2.00,2.55) mmoL/L.There were significant differences in the level of serum calcium of different days (P ＜ 0.05).On the second and third day,the change of serum calcium were 0.46 (0.10,0.88) mmol/L,0.60 (0.25,0.75) mmol/L,there were no differences.After intravenous disodium pamidronate,the serum calcium level decreased below 3.5 mmol/L in (2.27 ± 0.65) days,and were kept below 3.5mmol/L for 18.45 ± 12.30 days.Conclusions Disodium pamidronate can decrease serum calcium levels in hypercalcemic crisis caused by primary hyperparathyroidism effectively with mild adverse events.

Objective To discuss the intraoperative and postoperative effects of conbercept combined with pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR) patients.Methods From January 2016 to December 2016,123 PDR patients (149 eyes) aged 41-65 years old with nonclearing vitreous hemorrhage (VH) and/or tractional retinal detachment (TRD) were enrolled in this study.According to whether preoperative intravitreal injection conbercept,the patients were divided into two groups:Conbercept group (64 cases,78 eyes),Control group (59 cases,71 eyes).Conbercept group was treated with intravitreal injection of Conbercept 0.50 mg (0.05 mL) at 3 days before PPV.Then the standard 23G minimally invasive sclera three-channel vitrectomy was performed if no significant complications after the injection of conbercept.The operation time,intraoperative bleeding,iatrogenic retinal hole,use of endodiathermy and silicone oil,and postoperative complications were recorded and analyzed.The visual acuity and macuiar thickness were compared before and 1 month after the surgery.Results Two groups had no difference on age,sex,HbA1 C,duration,VH ≥ three degree(56/78,45/71),TRD.Conbercept pretreatment could significantly reduce the bleeding during PPV (43/78,49/71),the probability of iatrogeuic retinal holes (11/78,21/71),reduce intraocular electrocoagulation using (57/78,62/71) and silicone oil (43/78,51/71),and then shorten the operation time (58.63 ± 21.66)s and (72.69 ± 22.48)s,and it could significantly improve the postoperative visual acuity (0.23 ± 0.15,0.16 ± 0.11) and macular edema thickness (260.95 ± 27.44) μm and (330.81 ± 36.62)μm,while reduce the incidence of second bleeding (3/78,10/71).Conclusion Conbercept pre-treatment combined with PPV for PDR is a positive and effective treatment,which has good clinical application significance.

Pimavanserin is a selective 5-HT2A receptor inverse agonist approved by FDA on April 29, 2016, and it is the first drug for the treatment of hallucinations and delusions associated with Parkinson' s disease. Pimavanserin is with high safety, good toleration and promising clinical efficiency, which is a timely option to resolve the drug shortage in clinic treatment. This paper summarized its pharmacodynamics, pharmacokinetics, clinical studies, adverse reactions and drug interactions.

BACKGROUND:Compared with organic fluorescent dyes and fluorescent proteins, rare earth nanomaterials have higher sensitivity, better optical stability, and lower cytotoxicity. OBJECTIVE: To investigate thein vitro cytocompatibility of (Y0.95Eu0.05)2O3 METHODS:(Y rare earth nanomaterial and the effect of amine functionalization on the material cytocompatibility. 0.95Eu0.05)2O3 nanomaterials were synthesized using sol-gel method, and underwent amine functionalization. Amine-functionalized samples (10, 25, 50, 100, 200 mg/L) and non-amine-functionalized (Y0.95Eu0.05)2O3 rare earth nanomaterial suspensions were co-cultured with vascular smooth muscle cels of Sprague-Dawley rats for 3 days. Cel proliferation was detected using Cel Counting Kit-8 assay. 100 mg/L amine-functionalized samples and non-amine-functionalized (Y0.95Eu0.05)2O3 rare earth nanomaterial suspensions were co-cultured with L929 cels for 48 hours. Cel apoptosis was observed using fluorescence staining. RESULTS AND CONCLUSION:With increased mass concentration of material suspension, survival rate of vascular smooth muscle cels was gradualy reduced. At the mass concentration of 10, 25, 50 mg/L, cel survival rate was significantly higher in the amine-functionalized group than in the non-amine-functionalized group (P < 0.05). When the mass concentration of materials reached 200 mg/L, the cel survival rate decreased to 76% in the non-amine-functionalized group, but it was stil above 80% in the amine-functionalized group, showing significant differences between the two groups (P < 0.05). The growth of L929 cels was good and the number of apoptotic cels was less in the amine-functionalized group. Cels were sparse and the number of cel apoptosis was more in the non-amine-functionalized group, showing slight cytotoxicity. These data verified that amine-functionalization can improve cytocompatibility of (Y0.95Eu0.05)2O3 rare earth nanomaterial.

AIM: To analyze the effects of two kinds of anti-vascular endothelial growth factor (VEGF) drugs, conbercept and ranibizumab, on proliferative diabetic retinopathy (PDR) patients as pre-treatment for pars plana vitrectomy (PPV).METHODS: From June 2016 to December 2016, 62 patients (64 eyes) aged 41-59 years old diagnosed with PDR with nonclearing vitreous hemorrhage (VH) and/or tractional retinal detachment (TRD) requiring PPV were enrolled in our study.Patients were treated with intravitreal injection of anti-VEGF drugs 0.50mg (0.05mL) 3d before PPV.Then the standard 23G minimally invasive sclera three-channel vitrectomy was performed where there were no significant complications after the injection of anti-VEGF drugs.The operation time, intraoperative bleeding, iatrogenic retinal breaks, the use of endodiathermy and silicone oil, and postoperative complications were recorded and analyzed.We compared and analyzed the visual acuity and macular thickness before and 1mo after the surgery with the preoperative data.RESULTS: Both conbercept and ranibizumab could improve the postoperative visual acuity and reduce the postoperative macular thickness of PPV.There was no significant difference between the impacts of two kinds of anti-VEGF drug pre-treatment on operation time, intraoperative bleeding, iatrogenic retinal breaks, the use of endodiathermy, silicone oil filling and postoperative vitreous secondary hemorrhage.CONCLUSION: The effects of conbercept and ranibizumab pre-treatment were similar.PPV combined with anti-VEGF pre-treatment could improve postoperative visual acuity and macular edema.The choice of conbercept or ranibizumab should be made flexibly according to the actual situation of patients.

As a member of nuclear receptor superfamily, farnesoid X receptor (FXR) has been shown to regulate numerous metabolic pathways, which include playing an important role in bile acid metabolism, maintaining lipid and glucose homeostasis when FXR is activated. With the prevalence of the glucose and lipids disorder, FXR attracts increasing attention. It may be a potential target for the treatment of type 2 diabetes mellitus and lipid disorders.
Bile Acids and Salts ; Diabetes Mellitus, Type 2 ; Glucose ; metabolism ; Homeostasis ; Humans ; Lipid Metabolism ; Receptors, Cytoplasmic and Nuclear ; metabolism

Objective To report a case of pulmonary alveolar microlithiasis ( PAM) in Peking Union Medical Col-lege Hospital and to summarize the clinical features and genetic characters .Methods The clinical features , ima-ging results , pathology findings and SLC34 A2 gene mutation was analyzed and reported .Results The patient was a 35 years old male, presenting with cough and sputum for 10 years and worsen with short of breath for 3 weeks. Computed tomography of lung and pathology findings support the diagnose of pulmonary alveolar microlithiasis .And a heterozygous mutation c .A910 T in exon 8 of SLE34 A2 gene was discovered through genetic testing .Conclusions Since to the treatment is non-specific in this rare disease , it's significantly important to recognize this disease through early non-specific clinical features but typical imaging findings .And the finding that c .A910 T is more common in Asia population may provide us a potential target for screening and possible genetic engineering therapy .

For a long time, limited by the factors such as laparoscopic technology, and limited medical resources , the residents accepting standardized training are lack of mastery of the technology . Meanwhile, it is the key to the training of personnel training and reserve in the field for residents to contact the laparoscope as soon as possible and carry out scientific and effective training. Therefore, based on the traditional method, we have developed a new type of laparoscopic teaching system for the standardized training residents and increased and integrated the LAP GAME R operations training system and the real-time multimedia teaching platform. The preliminary practice effect is good.