A 39-year-old female with central diabetes insipidus complained of polydipsia and polyuria and was found to be accompanied by lung lesions. The diagnosis of IgG4-related disease was confirmed by laboratory and pathological results. It should be alert to consider the possibility of IgG4-related disease in a patient with central diabetes insipidus coexisting with the signs of multisystem lesions such as lung disease.

Osteoporosis(OS)is a systemic skeletal disorder characterized by low bone mass and increased risk of fracture.Bone mineral density(BMD)is a gold standard in the diagnosis of OS,but is not sensitive enough for detecting the earlier bone loss.Bone metabolic markers have high sensitivity and specificity.Therefore,they are able to reflect the early changes of bone mass and can be used to monitor the efficacy of anti-OS agents.This article summarizes the research advance in both traditional and newly identified bone metabolic markers.

[Summary] A 19-year-old male patient with central diabetes insipidus complained of polydipsia and polyuria and was found to be accompanied by cervical vertebra lesions.The diagnosis of Langerhans cell histiocytosis was confirmed by laboratory and pathological results.Therefore,it should be alert to consider the possibility of Langerhans cell histiocytosis in a patient with central diabetes insipidus coexisting with the signs of multisystem lesions such as bone disease.

Objective To investigate the effects and mechanism of glucagon-like peptide-1 ( GLP-1 ) receptor agonist liraglutide on the proliferation and apoptosis of human pancreatic cancer cells. Methods The human pancreatic cancer cell line MIA PaCa-2 was incubated for 24 h with liraglutide at various concentrations (10-1 000 nmol/ L), or with 100 nmol/ L liraglutide for various durations (0-72 h). Cell proliferation was determined by Cell Counting Kit-8 (CCK-8) analysis. RT-PCR and Western blot were used to detect the mRNA and protein expression levels of related genes. Results GLP-1 receptor was expressed in the MIA PaCa-2 cells. Liraglutide suppressed cell proliferation, up-regulated the expression levels of pro-apoptotic protein Bax and down-regulated the expression levels of anti-apoptotic protein Bcl2 in human pancreatic cancer cells in a dose- and time-dependent manner. Meanwhile, liraglutide down-regulated the expression levels of insulin receptor (INSR) and insulin-like growth factor-1 receptor (IGF-1R), and the phosphorylation levels of their downstream signaling proteins Erk1 / 2 and Akt, in a dose- and time-dependent way. Conclusion Liraglutide inhibits proliferation and promotes apoptosis of human pancreatic cancer cells; the process may be mediated via suppressing the expression of INSR and IGF-1R and inhibiting activation of the downstream MEK/ Erk1 / 2 and PI3k/ Akt pathways.

Objective To evaluate the structure and function of left ventricle in diabetes mellitus (DM) patients without complications by myocardial velocity gradient (MVG) measured by myocardial velocity profile (MVP). Methods Thirty type 2 DM patients without complications and 30 healthy volunteers as controls were enrolled. The heart structure, systolic function and diastolic function of left ventricle were measured by echocardiography and the left ventricular mass index (LVMI) was calculated. Mitral annular systolic movement (Sm) , early rapid filling phase movement ( Em) and atrial contraction movement(Am) were measured by tissue Doppler image and the left ventricular MVG at diastole and systole in subendocardium and subepicardium (MVGs,MVGd) were measured by MVP. Results The diameter of left atria and left ventricle, thickness of interventricular septum and LVMI were higher in DM group than those of control group ( P <0. 05 or P <0. 01) , MVGs, MVGd, and Em were lower in DM group than those of control group( P <0. 05 or P <0. 01). There were no significant differences on E/A, Em/Am and E/Em between two groups. In addition, there were also no significant differences on Sm,left ventricular ejection fraction and left ventricular fraction shortening between two groups. Conclusions Structure and function of left ventricle have changed in patients of DM without complications. MVG measured by MVP is an accurate and sensitive index to assess left ventricular systolic and diastolic function.

Objective To observe the analgesic and anti-inflammatory effects of the water extract of Glycosmis citrifolia (Willd.) Lindl.on mice and explore the mechanism. Methods The analgesic and anti-inflammatory effects were evaluated by 0.7% acetic acid-induced writhing test,the hot plate test,tests of dimethylbenzene-induced ear swelling,1% carrageenan-induced paw edema,determination of PGE2 in inflammatory feet,0.6% acetic acid-induced increase in peritoneal capillary permeability and cotton ball granuloma. Results The water extract of Glycosmis citrifolia (Willd.) Lindl.at low,medium and high doses can reduce the acetic acid-induced writhing times (P<0.01 or P<0.05),increase the pain threshold of mice (P<0.01 or P<0.05), inhibit dimethylbenzene-induced ear swelling (P<0.01 or P<0.05),1% carrageenan-induced paw edema (P<0.01 or P<0.05) and PGE2 production (P<0.01),0.6% acetic acid-induced increase of peritoneal capillary permeability (P<0.05),and the de-velopment of cotton ball granuloma (P<0.01 or P<0.05). Conclusion The water extract of Glycosmis citrifolia (Willd.) Lindl.shows analgesic and anti-inflammatory effects on mice.

To evaluate effects of PDCA cycle in improving residency diagnosis and treatment ability of endocrine and metabolic diseases, this paper selected the problems of insufficient diagnosis and treatment ability in the results of the 2016 endocrinology examination paper as the research breakthrough point, and investigated 62 residents receiving standardized residency training to analyze main reasons of the problems such as "busy clinical work", "special clinical thinking" and "difficult to remember knowledge of endocrinology". The online teaching, daily self-education, following the law of memory to remember and re-recognize knowledge, strengthening the construction of teachers, improving teaching methods were used and evaluated. It’s found that the application of PDCA cycle can improve the residents' ability of clinical diagnosis and treatment in endocrine and metabolic diseases.

To evaluate effects of PDCA cycle in improving residency diagnosis and treatment ability of endocrine and metabolic diseases, this paper selected the problems of insufficient diagnosis and treatment ability in the results of the endocrinology examination paper as the research breakthrough point, and investigated 62 residents receiving standardized residency training to analyze main reasons of the problems such as "busy clinical work", "special clinical thinking" and "difficult to remember knowledge of endocrinology". The study implemented information-based teaching and daily self-education, followed the law of memory, strengthened the construction of teaching staff, improved teaching methods, etc., and effects of these methods were assessed after the teaching. It's found that the application of PDCA cycle can improve the residents' ability of clinical diagnosis and treatment in endocrine and metabolic diseases.

Androgen receptor (AR) is a ligand-activated transcription factor that plays a pivotal role in the development and progression of many severe diseases such as prostate cancer, muscle atrophy, and osteoporosis. Binding of ligands to AR triggers the conformational changes in AR that may affect the recruitment of coactivators and downstream response of AR signaling pathway. Therefore, AR ligands have great potential to treat these diseases. In this study, we searched for novel AR ligands by performing a docking-based virtual screening (VS) on the basis of the crystal structure of the AR ligand binding domain (LBD) in complex with its agonist. A total of 58 structurally diverse compounds were selected and subjected to LBD affinity assay, with five of them (HBP1-3, HBP1-17, HBP1-38, HBP1-51, and HBP1-58) exhibiting strong binding to AR-LBD. The IC values of HBP1-51 and HBP1-58 are 3.96 µM and 4.92 µM, respectively, which are even lower than that of enzalutamide (Enz, IC = 13.87 µM), a marketed second-generation AR antagonist. Further bioactivity assays suggest that HBP1-51 is an AR agonist, whereas HBP1-58 is an AR antagonist. In addition, molecular dynamics (MD) simulations and principal components analysis (PCA) were carried out to reveal the binding principle of the newly-identified AR ligands toward AR. Our modeling results indicate that the conformational changes of helix 12 induced by the bindings of antagonist and agonist are visibly different. In summary, the current study provides a highly efficient way to discover novel AR ligands, which could serve as the starting point for development of new therapeutics for AR-related diseases.
Androgen Receptor Antagonists ; pharmacology ; Androgens ; metabolism ; pharmacology ; Biological Assay ; Cell Line, Tumor ; Drug Discovery ; methods ; Humans ; Ligands ; Male ; Molecular Docking Simulation ; Molecular Dynamics Simulation ; Phenylthiohydantoin ; analogs & derivatives ; pharmacology ; Principal Component Analysis ; Prostatic Neoplasms ; drug therapy ; Protein Binding ; physiology ; Protein Conformation ; drug effects ; Receptors, Androgen ; metabolism