Glucagon-like peptide 1(GLP-1) is an important member of incretin.Takingitoralymay stimulate the terminal ileum and colon L cel s to secrete GLP-1. After GLP-1 biding specific receptor GLP-1 receptor ( GLP-1R), it exerts the roles of promoting glucose-dependent insulin secretion, inhibiting glucagon secretion, and decreasing plasma glucagon level. The molecular mass of GLP-1 is relatively smal er and can directly cross the blood-brain barrier, and both central and peripheral nervous systems have the GLP-1R expression. GLP-1 significantly improves neurological deficits and reduces infarct volume. It may exert neuroprotective effect through the mechanisms of inhibiting the inflammatory response, oxidative stress, and cel apoptosis. This article review s the discovery of GLP-1, its biological characteristics and neuroprotective effect in cerebral ischemia.

Objective To observe the cervical regeneration outcome after different loop electrosurgical excision procedures(LEEP) for the management of cervical lesions.Methods A total of 209 patients with cervical lesions including cervical epithelial neoplasia,cervical HPV infection,cervical polyp and condyloma,and severe cervicitis were performed LEEP in our hospital.The types of LEEP included shallow ring excision,deep ring excision,LEEP conization,and that similar to cold-knife conization.The width and depth of removed cervical tissues were recorded,and the cervical regeneration was observed during the follow-up. Results Among the 209 cases,179(85.6%) were satisfactory cervical regeneration,24(11.5%) were little satisfactory cervical regeneration,and 6(2.9%) were unsatisfactory cervical regeneration.Shallow ring excision,deep ring excision and cone excision had higher satisfactory situation.Extroversion of cervical columnar epithelium was observed in 15 cases(7.2%) in little satisfactory cervical regeneration.Severe extroversion of cervical columnar epithelium of 3 cases occurred in unsatisfactory cervical regeneration.Besides,there were 2 case of cervical shortening and 1 case of severe erythema in unsatisfactory cervical regenerations. Conclusion Although having such complications as extroversion of cervical columnar epithelium,cervical shortening and erythema,LEEP performs a high satisfactory cervical regeneration after management of cervical lesions.It is in great need to analyze the condition of different patients in managing cervical lesions by LEEP.

Objective To explore the correlation between high-risk human papillomavirus(hr-HPV) viral load and severity of cervical lesion. Methods One thousand eight hundred and six women undergoing both hr-HPV DNA test by hybrid capture Ⅱ(HCⅡ) and colposcopic biopsy for histologic results were enrolled in this study.Correlation between hr-HPV viral load and pathological findings was investigated. Results Of 1 806 cases,641(35.5%) patients were positive for HPV DNA.23.2%(301/1299) of women with normal diagnosis had HPV infection,significantly lower than cervical lesion including cervical intraepithelial neoplasia(CIN) and cervical cancer(P=0.000).Associations(odds ratio) among severity of cervical lesion and viral load were calculated.The significantly increased risk only existed between cervical cancer and CIN1 on high viral load(odds ratio,8.5;95% confidence interval,1.0-71.4;P=0.049).Furthermore,viral load values in CIN1,2,3 and cervical cancer were calculated and median analysis revealed non-significant difference(P=0.712). Conclusion The hr-HPV viral load can distinguish cervical lesion as CIN and cervical cancer from normal one,while the prediction of the severity of cervical lesion may be inadequate and need further investigations.

Objective To investigate the diagnostic value of thinprep cytologic test(TCT) and electronic colposcope(EC) examination in patients with subclinical human papillomavirus(HPV) infection(SPI) and cervical intraepithelial neoplasia(CIN),and explore its concordance with pathologic diagnosis. Methods A total of 1 125 females were examined with TCT,744 of whom diagnosed with abnormality by TCT or suspect of cervical lesions were examined with EC,and multiple punch biopsies were performed in 706 of those with abnomal EC images and suspected diseases. ResultsThe sensitivity of TCT,EC examination and the combined examination of TCT and EC for SPI and CIN were 88.74%,88.79% and 90.63%,respectively,the specificity 85.44%,80.38% and 96.41%,respectively,the positive predictive value 74.06%,68.90% and 91.10%,respectively,and the negative predictive value 94.19%,93.61% and 96.21%,respectively.By the combination of the two examinations,the specificity and positive predictive value were significantly increased(P

ObjectiveTo explore the influence of early enteral nutrition (EEN) on the immune function and outcome in patients with severe traumatic brain injury.MethodsTotally 131 patients with severe traumatic brain injury who were admitted to the Intensive Care Unit of our hospital between March 2010 and March 2011 were enrolled in this study.Among them,69 were in EEN group and 62 were in control group.On day 7,humoral immune function was measured using automatic biochemistry analyzer,and the peripheral blood lymphocyte subset proportions were measured using flow cytometry.The complications were recorded in the initial 7 days after trauma.ResultsCompared with the control group,the EEN group had significantly lower incidences of complications including glucose metabolism disorder,diarrhea/stomach intestine distend,infection,multiple organ dysfunction syndrome,and stress ulcer on day 7 ( P =0.000,0.002,0.001,0.004,and 0.002).Hospital mortality in the EEN group was also significantly lower than that in control group ( P =0.028).The serum levels of IgM and IgG in EEN group were significantly higher than in control group ( both P =0.000),whereas the serum levels of C3 and C4 in the EEN group were significantly lower ( both P =0.000).IgA showed no significant difference between these two groups (P =0.144).The serum levels of CD3 + CD4 + T lymphocytes,CD4 +/CD8 + T lymphocytes,and CD19 + lymphocytes in the EEN group were significantly higher than in control group (all P =0.000),while CD3 + CD8 + T lymphocytes showed no significant difference ( P =0.070 ),The serum level of CD16+ CD56+ T lymphocytes in the EEN group was significantly lower than that in control group (P =0.026).ConclusionPatients with severe traumatic brain injury have good tolerance of EEN,which may enhance the immune function and improve the outcome of the patients.

Carrier State ; virology ; Female ; Hepatitis B ; complications ; Humans ; Lymphoma, Large B-Cell, Diffuse ; virology ; Male ; Middle Aged

To explore the clinic characters,treatments and prognosis of patients with primary bone lym-phoma( PLB ) .The clinical symptoms, signs, X -ray features, pathological morphology, immunophenotype and treatment of 7 patients with PLB were analyzed retrospectively and the pertinent literatures were reviewed.The re-sults showed that the main complains of 7 cases of PBL were local pain.The CT showed osteolytic bone destruc-tion and soft tissue swelling.There were 3 cases of diffuse large B cell lymphoma,1 case of Burkitt-type lympho-ma,1 case of periferal T-cell lymphoma,1 case of anaplastic large cell lymphoma,and 1 case of Hodgkins lym-phoma.2 patients presented with stageⅠ,4 with stageⅡ,and 1 with stage 3.The therapeutic procedure includes local radiotherapy combined with chemotherapy and targeted therapy.The clinical presentation of PLB is not spe-cial.The diagnosis and identification of histological type of PLB should be established by histopathological and im-munohistochemistry examinations.Early diagnosis and active therapy could improve the prognosis of PLB.Combi-nation therapy including radiotherapy and chemotherapy is the optimal treatment for PLB.

Objective To investigate the effect of BRAFV600E mutation on the invasion capacity of a human melanoma cell line, A375. Methods Plasmids containing short hairpin RNAs (shRNA) specific for BRAF gene were prepared in previous study, and used to transfect A375 cells. Those cells transfected with negative plasmid and untransfected cells served as the controls. Transwell chambers were used to examine the invasion ability of melanoma cells in vitro. RT-PCR and Western blotting were performed to detect the mRNA and protein expressions of matrix metalloproteinase 2 (MMP-2) and vascular endothelial growth factor (VEGF), respectively, before and after the transfection. The activity of MMP-2 was also studied with sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE). Results Compared with the negative control, the specific shRNA decreased the mRNA and protein expressions of MMP-2 by 35% and 85%, respectively, and those of VEGF by 45% and 14%, respectively. Additionally, the number of cells invading through Matrigel chambers reduced by 69% in those cells transfected with the positive plasmid. Conclusions The mutant BRAFV600E has the potential to enhance the invasion capacity of melanoma cells, whereas specific shRNA could suppress the increase in metastasis capacity likely by inhibiting the production of VEGF and MMP.

OBJECTIVETo summarize the clinical experience and the role of hepatectomy with portal vein resection and reconstruction hilar cholangiocarcinoma.

METHODSFrom 1998 to 2003, the clinical records of 118 cases with hilar cholangiocarcinoma were reviewed.

RESULTSOf the 118 patients, 66 were performed palliative treatment; and 52 patients underwent radical resection, of which 47 patients, including 11 cases combined with portal vein resection and reconstruction, underwent hepatectomy. The rate of postoperation complication was 22.9% and 27.3% in hepatectomy with or without portal vein resection and reconstruction respectively. The 1, 3-year survival rate were 85.7%, 31.4% and 81.8%, 27.8% in hepatectomy with or without portal vein resection and reconstruction respectively (P > 0.05). Only 5 patients were alive more than 3 years (7.58%), and no patient with palliative treatment lived over 5 years.

CONCLUSIONSPortal vain invasion is not the contraindication of resection for hilar cholangiocarcinoma. Hepatectomy with portal vein resection and reconstruction may raise the radical resection rate of hilar cholangiocarcinoma and improve the results of prognosis.

Adult ; Aged ; Bile Duct Neoplasms ; pathology ; surgery ; Bile Ducts, Intrahepatic ; Cholangiocarcinoma ; pathology ; surgery ; Female ; Follow-Up Studies ; Hepatectomy ; methods ; Humans ; Male ; Middle Aged ; Neoplasm Invasiveness ; Portal Vein ; pathology ; surgery ; Prognosis ; Reconstructive Surgical Procedures ; Retrospective Studies ; Treatment Outcome

BACKGROUNDRecently, it has been suggested that the serum uric acid (SUA) level decreased in diabetic patients. The aim of this study was to explore the association between SUA level and different state of glucose metabolism and glomerular filtration rate (GFR) reflected by the simplified Modification of Diet in Renal Disease (MDRD) equation and to test the hypothesis that high MDRD is one of the determinants of SUA level.

METHODSThis cross-sectional study included 2373 subjects in Beijing who underwent a 75 g oral glucose tolerance test (OGTT) for screening of diabetes. According to the states of glucose metabolism, they were divided into normal glucose tolerance, impaired glucose regulation and diabetes.

RESULTSMultiple stepwise linear regression analysis showed that adjusted by gender, SUA was positively correlated with body mass index (BMI), waist/hippo ratio, systolic blood pressure (SBP) and triglyceride, meanwhile negatively correlated with age, hemoglobin A1c, fasting insulin and MDRD. There was an increasing trend in SUA concentration and a decreasing trend in MDRD when the levels of fasting plasma glucose (FPG) increased from low to high up to the FPG level of 8.0 mmol/L; thereafter, the SUA concentration started to decrease with further increases in FPG levels, and the MDRD started to increase with further increases in FPG levels.

CONCLUSIONThis study confirmed the previous finding that SUA decreased in diabetes and provided the supporting evidence that the increased MDRD might contribute to the fall of SUA.

Adult ; Aged ; Blood Glucose ; metabolism ; Cross-Sectional Studies ; Female ; Glomerular Filtration Rate ; physiology ; Humans ; Linear Models ; Male ; Middle Aged ; Uric Acid ; blood