OBJECTIVE:To evaluate the clinical efficacy of liraglutide and insulin glargine in the treatment of type 2 diabetes mellitus (T2DM) and conduct pharmacoeconomic analysis, and to provide economical and reasonable T2DM treatment plan. METHODS:80 T2DM patients were randomized into liraglutide group and insulin glargine group,with 40 cases in each group. Both groups were given Metformin hydrochloride sustained-release tablet orally 0.5-2.0 g/d,and diabetes mellitus diet and sport training guide after oral antidiabetic drug withdrawal of previous treatment plan. Liraglutide group was given Liraglutide injection hypodermically,0.6-1.2 mg,qd;insulin glargine group was given insulin glargine hypodermically at 22 o’clock,initial dose of 0.2 IU/(kg·d),adjusted according to the levels of PG,FBG,nocturnal blood glucose level till FBG≤7 mmo1/L and 2 h PG ≤10 mmol/L in both group. Treatment course of 2 groups lasted for 12 weeks. The changes of FBG,2 h PG,HbA1c and BMI were ob-served in 2 groups before and after treatment. 2 therapy plans were evaluated and compared by cost-minimization analysis. RE-SULTS:After treatment,the levels of FBG,2 h PG and HbA1c decreased significantly in 2 groups,compared to before treatment, with statistical significance (P<0.05),but there was no statistical significant difference between 2 groups (P>0.05). After treat-ment,BMI of liraglutide group decreased significantly compared with before treatment and insulin glargine group,with statistical significance (P<0.05). There was no statistical significant difference in BMI of insulin glargine group before and after treatment (P>0.05). Cost-minimization analysis showed that the cost of insulin glargine group in reducing FBG,2 h PG and HbA1c were less than liraglutide group,but were more than liraglutide group in reducing BMI. Sensitivity analysis demonstrated the stability and reliability of cost-minimization analysis. CONCLUSIONS:Lira-glutide and insulin glargine have the same clinical efficacy,but insulin glargine need lower cost in blood glucose control,and liraglutide is better therapy plan for body weight control.

OBJECTIVETo investigate the clinical efficacy of estrogen in management of postpartum hemorrhage due to uterine atony.

METHODSTotalling 112 puerperants with postpartum hemorrhage due to uterine atony were randomly assigned into 2 groups and received routine managements for uterine atony such as uterine massage and uterotonics administration. The puerperants in one group (n=52) was treated with 4 mg estradiol benzoate injected intramuscularly, and the amount of blood loss 2 h after delivery and between 2 and 24 h after delivery was recorded.

RESULTSThere were significant differences in vaginal blood loss at 2 h after delivery between the 2 groups (P<0.05). The puerperants with estrodiol benzoate treatment had blood loss of 589.6-/+226.4 ml at 2 h and 110.8-/+76.2 ml within 2-24 h after delivery, which were both less than those in the control group (864.5-/+359.5 ml and 161.5-/+98.3 ml, respectively). Postpartum hysterectomy was performed in 3 cases of the control group while none in estradiol benzoate-treated group. In the mothers and neonates, no major adverse effects were observed.

CONCLUSIONEstrogen shows cooperative efficacy with uterotonics in stimulating uterine contraction for managements of postpartum hemorrhage due to uterine atony, and can be of value in clinical application.

Adult ; Delivery, Obstetric ; adverse effects ; Drug Therapy, Combination ; Estradiol ; analogs & derivatives ; therapeutic use ; Female ; Humans ; Oxytocics ; therapeutic use ; Postpartum Hemorrhage ; drug therapy ; etiology ; Pregnancy ; Treatment Outcome ; Uterine Inertia ; drug therapy

OBJECTIVETo study the differences between epidemic strains of influenza virus subtype A3 circulated in China and Occident in past 18 years, in genetic level, and vaccine strains recommended by WHO in corresponding time.

METHODSAmino acid sequences of HA1 regions of the epidemic strains, which circulated in China and Occident from 1988 to 2005, and the vaccine strains of influenza virus subtype A3 were compared by BioEdit and analyzed on the differences of HA1 and it's antigen determinants

RESULTSDifferences between epidemic strains and vaccine strains recommended in corresponding year, both in HA1 and it' s antigen determinant regions, were obviously greater than that between epidemic strains and vaccine strains recommended in next round (P< 0.01). However, differences between epidemic strains in Occident and vaccine strains recommended in corresponding year were slightly greater than that between epidemic strains and vaccine strains recommended in next round and it was not marked (P >0.05). In addition, differences between epidemic strains and vaccine strains which being used for several years, whether in China or in Occident, constantly increased accompanying the used time prolonged.

CONCLUSIONThere was an obvious lag between vaccine strains recommended by WHO, analyzed in genetic level, and epidemic strains of influenza virus subtype A3 circulated in China.

Antigens, Viral ; analysis ; China ; epidemiology ; Hemagglutinin Glycoproteins, Influenza Virus ; analysis ; Humans ; Influenza A virus ; classification ; Influenza Vaccines ; Influenza, Human ; classification ; epidemiology ; prevention & control

BACKGROUNDIt is essential to establish an animal model for the elucidation of the biological behaviors of stem cells in vivo. We constructed a chimeric animal model by in utero transplantation for investigation of stem cell transplantation.

METHODSThis chimerism was achieved by injecting the stem cells derived from the bone marrow of green fluorescence protein (GFP)-transgenic mice into fetal mice at 13.5 days of gestation. Several methods such as polymerase chain reaction (PCR), real-time PCR, fluorescence-assisted cell sorting (FACS) and fluorescence in situ hybridization (FISH) were used for the observation of donor cells.

RESULTSUnder a fluorescence microscope, we observed the GFP cells of donor-origin in a recipient. PCR, FACS analysis and FISH indicated chimerism at various intervals. Real-time PCR indicated that some donor cells existed in chimera for more than 6 months.

CONCLUSIONSAllogenic stem cells may exist in recipients for a long time and this allogenic animal model provides a useful tool for studying the behavior of hematopoietic stem cells and also offers an effective model system for the study of stem cells.

Animals ; Female ; Flow Cytometry ; Hematopoietic Stem Cell Transplantation ; In Situ Hybridization, Fluorescence ; Mice ; Models, Animal ; Polymerase Chain Reaction ; Transplantation Chimera ; Transplantation, Homologous

Objective To analyze the relationship between influenza epidemic and genetic characteristic on the whole genome of influenza virus subtype A/H3N2 strains isolated in Zhejiang province during 1998 to 2009. Methods All of the eight genes from the 19 Zhejiang influenza virus isolates, circulated during 1998 to 2009, were amplified by RT-PCR and sequenced. The obtained sequences were aligned and analyzed with the vaccine strains being used in the last 10 years.Results The highest mutation happened within HA and NA genes and the amino acid divergent ratios were 13.98% and 10.00%. Amongst the six internal proteins, the amino acid divergent ratios of NP, M2 and NS1 were 6.43%, 6.19% and 3.48% respectively, and the others were lower than 3%.Other than the HA and NA genes, mutations were also observed on six internal genes of the strains isolated in those years when the influenza virus subtype A/H3N2 was widely circulating.Additionally, there had been an obvious genetic lag between vaccine strains recommended by WHO and the contemporary Zhejiang epidemic strains for many years. Conclusion Besides on HA and NA genes, surveillance programs should also be covered mutations regarding the internal genes of influenza virus subtype A/H3N2 strains, in order to provide important information for forecasting and warning of a new round of influenza epidemic.

Objective To study the evolutionary characteristics and rules of two lineages on influenza B virus.Methods A total of 126 HA1 sequences of strains isolated during 1940 to 2012were downloaded from the GenBank.Time of the most recent common ancestor (TMRCA) and divergence of the two lineages were calculated based on the data from phylogenetic analysis of HA1gene,using Bayesian Markov Chain Monte Carlo (Bayesian-MCMC) and molecular clock method.Results The average amino acid variant ratios were ranged from 5.4％ to 10.2％ within the strains of influenza B virus isolated during 1978 to 2010.Compared with the Victoria-like strains,all Yamagatalike strains showed an amino acid deletion at 163th site,while some of them showing a deletion at position 166.HA1 gene of influenza B virus seemed not have been affected by positive selection except a few sites.The evolutionary average rate on HA1 gene was 2.138 × 10-3 substitutions/site/year (95％HPD:1.833 × 10-3-2.437 × 10-3 substitutions/site/year).The estimated dates for TMRCA of the two lineages of influenza B virus could be dated back to 1971 (95％ HPD:1969-1972),while the divergence times of the two lineages were 1973 (95％ HPD:1971-1974) and 1977 (95％ HPD:1975-1978) respectively.Conclusion Significant differences were found on HA1 gene between earlier and recent identified strains of Victoria and Yamagata lineage.Differences between the two lineages increased and showing the potential of dividing themselves into different subtypes in the future.More attention should be paid to these trends and the related epidemiological significance.

Objective To analyze the genetic characteristics of the complete sequence of coxsackievirus A24 variant(CA24v) isolated from acute hemorrhagic conjunctivitis (AHC) outbreaks in Zhejiang province during 2002 to 2010.Methods Complete sequences of CA24v epidemic strains isolated in different years were amplified under the RT-PCR assay,while the sequences of whole genome,VP1,and 3C region of Zhejiang strains were compared with epidemic strains isolated in other areas of China and abroad.Results The whole genome of Zhejiang CA24v strains isolated in 2002 and 2010 was 7456-7458 bp in length,encoding a polyglutamine protein which containing 2214 amino acid residues.There was a insertion with T on site 97 and 119 within 5' non-coding region between epidemic strain Zhejiang/08/10 and strains isolated in 2002.The rates of amino acid homology among Zhejiang/08/10 and other strains isolated since 2002 were between 94.7％ and 100.0％.Compared with the representative strains circulated within the recent 60 years,the largest average amino acid variations had been occurred on region 2A and 3A,with the ratios as 8.4％ and 7.3％ respectively.The smallest variation happened in region 3D,with the ratio only as 1.9％.The rates of stable amino acid variation on the whole genome between strains isolated since 1987 and 2002 were 38 and 20.P-distance within groups appeared that region 3C was more stable than VP1 of strains isolated in 2002-2010,and the 3D of early strain Jamaica/10628/87 might have had a nature of recombination but not observed on those epidemic strains in recent years.Conclusion Within the evolution of CA24v strains,the time course was more significant than the geographical differences.There had been sporadic epidemics of AHC caused by CA24v in Zhejiang province since 2002.

This study was purposed to explore the effect of different cytokine combinations on the expansion of the mononuclear cells drived from umbilical cord blood (CB) ex vivo and expression of CXCR4 and CD49d on CD34+ cells after expansion. Human fresh CB mononuclear cells were cultured in serum-free and stroma-free medium containing different combinations of cytokine for 7 days. At day o and 7, the total cells were counted, CD34+ cells and CD34+CXCR4+, CD34+CD49d+ cells were assayed by flow cytometry, and CFU were determined. According to the different combinations of cytokine, experiments were divided into four groups: control, SF group (SCF + FL), SFT group (SCF + FL + TPO) and SFT6 group (SCF + FL + TPO + IL-6). The results showed that the SF (SF group) combination supported only low expansion of total cells, CD34+ cells and CFU. The addition of TPO in SF group restored UCB stem/progenitors expansion to a higher level than that in SF group, while there was no difference between groups SFT and SFT6 (P > 0.05). The cytokine combinations in groups SF, SFT and SFT6 all could upregulate the expression levels of CD49d and CXCR4 on expanded cord blood CD34+ cells, but there were no significant differences between groups SF, SFT and SFT6 (P > 0.05). It is concluded that SCF + FL has no strong synergistic effects on primitive hematopoietic cells. TPO plays an important role in enhancing expansion of umbilical cord blood hematopoietic cells, while IL-6 only shows a neutral effect on it. SCF + FL + TPO combination not only promotes progenitor cells expansion but also upregulates the expression of CD49d and CXCR4 on CD34+ cells from cord blood.
Antigens, CD34 ; biosynthesis ; genetics ; Cytokines ; pharmacology ; Drug Synergism ; Fetal Blood ; cytology ; Humans ; Integrin alpha4 ; biosynthesis ; genetics ; Leukocytes, Mononuclear ; cytology ; Membrane Proteins ; pharmacology ; Receptors, CXCR4 ; biosynthesis ; genetics ; Stem Cell Factor ; pharmacology ; Thrombopoietin ; pharmacology

OBJECTIVETo analyze the consistency of evolution condition between HA gene and the whole genome of influenza virus subtype A/H3N2 strains isolated in Zhejiang province from 1998 to 2009, and to study the potential antigenic region on the whole genome.

METHODSThe sequences of whole genome of 19 Zhejiang influenza virus isolates circulated from 1998 to 2009, which conserved by influenza laboratory of Zhejiang Provincial Centre for Disease Prevention and Control, were amplified using RT-PCR assays. The obtained sequences were used to conduct phylogenetic analysis with 10 contemporaneous vaccine strains. Three methods, including comparison of the amino acid substitutions, calculation of the entropy value and the filtering of positive selection sites, were used to confirm the mutable sites on each gene.

RESULTSThe whole genome of influenza virus subtype A/H3N2 was 4466 amino acids in length, with 137 stable mutations. The 144, 158 aa of HA gene mutate four and three times respectively; 93, 143, 307, 370, 372 aa of NA gene and 450 aa of NP gene mutate twice, and there were 29% (12/41) and 77% (24/31) mutations of HA and NA genes occurred on the non-epitope regions respectively. Analysis of the entropy value suggest that many amino acid sites on the non-epitope regions were prone to mutation, including 3, 225, 361 aa of HA gene; 93, 143, 147, 150, 372 aa of NA gene; 113, 576, 586 aa of PB1 gene; 101,256, 382, 421, 437 aa of PA; 377, 450 aa of NP gene; 218 aa of M1 gene and 31 aa of M2 gene.

CONCLUSIONBased on the whole genome of influenza virus subtype A/H3N2 strains isolated in Zhejiang province in 1998 to 2009, there may be several unknown or new antigen sites existing on the non-epitope regions of HA and NA genes and parts of internal genes. The phylogenetic tree constructed based on the complete sequence was more comprehensive than on the HA gene to reflect the genetic relationship and law of evolution among the influenza virus strains.

China ; DNA Mutational Analysis ; DNA, Viral ; genetics ; Evolution, Molecular ; Genetic Variation ; Genome, Viral ; Influenza A Virus, H3N2 Subtype ; classification ; genetics ; isolation & purification ; Molecular Sequence Data ; Phylogeny ; Sequence Analysis

OBJECTIVETo investigate the correlation between blood concentrations of tacrolimus (FK506) and cystatin C (Cys C) and the effect of FK506 on glycolipid metabolism in renal transplant recipients.

METHODSA total of 325 patients receiving renal transplantation between August, 2014 and September, 2015 in Nanfang Hospital were divided into 4 groups according to the postoperative time (1 month group, 1-3 months group, 4-6 months group, and 7-12 months group). FK506 blood trough concentration was measured at the time of postoperative follow-up, and creatinine (Scr) and Cys C levels were also detected. Results Plasma FK506 concentration decreased with age in the recipients and showed a positive correlation with Cys C (r=0.985, P=0.015) but no obvious correlation with Scr (r=0.259, P=0.741). FK506 had no effect on blood glucose (5.53-5.59 mmol

CONCLUSIONFK506 does not affect the level of glycolipid metabolism in patients after renal transplantation. Cys C is positively related to blood concentration of FK506 in the renal transplantation recipients. The rational use of FK506 can improve the effectiveness and safety of the treatment in the recipients.