OBJECTIVE:To evaluate the improvement effects of sitagliptin on islet B-cell function in type 2 diabetic patients systematically,and to provide evidenced-based reference. METHODS:Retrieved from PubMed,Cochrane library,EMBase, CJFD,Wanfang database,VIP and CBM,RCTs about sitagliptin alone or combined with routine plan(trial group)vs. placbo alone or combined with routine plan(control group)in the treatment of type 2 diabetes were collected. Two reviewers independent-ly screened studies according to exclusion and inclusion criteria,extracted data,and assessed the methodological quality according to Cochrane Manual 5.1.0. Meta-analysis was performed by using RevMan 5.3 software. RESULTS:A total of 5 RCTs were includ-ed,involving 1253 patients. The result of Meta-analysis showed that changes of islet B cell function index(Homa-B)[sitagliptin alone group:MD=9.21,95%CI(4.16,14.25),P<0.001;drug combination group:MD=7.24,95%CI(0.80,13.68),P=0.03] and changes of insulin resistance index(Homa-IR)[sitagliptin alone group:MD=-0.40,95%CI(-0.44,-0.36),P<0.001;drug combination group:MD=-0.35,95%CI(-0.63,-0.07),P=0.02] of trial group were significantly better than those of control group,with statistical significance. CONCLUSIONS:Sitagliptin shows certain therapeutic efficacy in improving islet B cell func-tion and insulin resistance.

Objective: To study effects of tertiary rehabilitation training on upper limb motor function recovery in patients with cerebral hemorrhage.Methods: A total of 120 patients with cerebral hemorrhage, who were treated in our hospital from May 2013 to May 2015, were selected.According to random number table, they were randomly and equally divided into routine rehabilitation group and tertiary rehabilitation group, and both groups received the same routine medical treatment and nursing.Simple test for evaluating hand function scale (STEF), Fugal-Meyer motor assessment (FMA) and Brunnstrom limb motor function assessment were used to assess and compare limb recovery after rehabilitation training between two groups.Results: At the end of first month of rehabilitation training, there were no significant difference in STEF and FMA scores between two groups, P>0.05 both.On the end of second month of rehabilitation training and later, compared with routine rehabilitation group, there were significant rise in STEF score[end of second month: (3.3±0.5) scores vs.(4.2±1.1) scores, end of sixth month: (6.3±1.2) scores vs.(8.5±1.1) scores], total STEF score[(20.2±4.2) scores vs.(38.2±3.5) scores]and FMA score[end of second month: (28.4±3.6) scores vs.(33.4±2.7) scores, end of sixth month: (38.2±6.6) scores vs.(46.3±5.8) scores]in tertiary rehabilitation group, P<0.05 all.Compared with routine rehabilitation group after six-month rehabilitation training, there were significant rise in percentages of Brunnstrom stage V (23.33% vs.43.33%) and stage VI (6.67% vs.20.00%) in tertiary rehabilitation group(P<0.05 both).Conclusion: Tertiary rehabilitation training can significantly improve upper limb motor function in patients with cerebral hemorrhage, so it's worth extending.

Objective To approach the mechanism of foot reflective therapeutics to sub-health state. Methods 35 patients with sub-health state were treated with foot reflective therapeutics, to press the foot reflective section by using many manipulations (such as press, rotation, push, etc) or apparatuses, once every other day, ten times constituting one therapeutic course. Results In 35 patients, 27 (77.1%) had excellent results, 7 good and one fair, the good rate was 97.1%. Conclusions Foot reflective therapeutics can regulate functions of viscera and dredge meridians on the basis of its convenient and effective characters.

Objective To summarize the management and diagnosis of testicular tumors in children.Methods The clinical characteristics, diagnosis, treatment and outcome of patients with pediatric testicular tumors, who were referred to Department of Pediatric Surgery, Shengjing Hospital of China Medical University from January 2003 to December 2013 ,were analyzed retrospectively.Results All of the 76 prepubertal patients were diagnosed initially with a painless scrotal mass.The mean age of the patients at diagnosis ranged from 1 to 156 months[mean(32.3 ±4.4) months].There were 39 cases(51.3％) with ages of0-1 years,18 cases (23.7％) with ages of 1-3 years,10 cases (13.2％) with ages of ＞ 3-7 years,9 cases(11.8％) with ages of ＞ 7-14 years.There were 37 cases in left side and 39 cases in right.And there were 59 cases (77.6％)of benign tumors and 17 cases(22.4％)of malignant tumors.Of the benign tumors,42 cases(55.2％)were teratomas, including 34 cases of mature teratoma and 8 cases of immature teratoma;11 cases were epidermoid cyst;11 cases were other benign tumors as lymphangioma.Among the 17 cases of malignant tumors, 16 cases (21.1％) were yolk sac tumors, which were I stage;1 case was embryoma.Thirty-three patients had abnormal alpha fetoprotein (AFP)concentrations before surgery,including 9 patients with mature teratoma,7 patients with immature teratoma, 16 patients with yolk sac tumors, 1 patient with embryonal carcinoma of testis.Of the 59 cases of benign tumors,testis-sparing surgery was done in 50 tumors, the other 9 patients underwent testis-excising because of tumor severely oppressing testis.All the 17 cases of malignant tumors underwent testis-excising.There were 76 cases in the follow-up.One patient with yolk sac tumor died for pulmonary metastasis during the follow-up.Others were alive and free of tumor recurrence.Conclusions The age range of the prepubertal testicular onset was 1 year or younger, most of the tumors were benign, and the most common subtype was teratoma.AFP highly expressed in yolk sac tumors, it was help to diagnosis.Testis-sparing surgery should be performed for the benign tumors and testis-excising for the malignant tumors.

Using hybridoma technique,17 hybridoma cell lines against astrocyte were ob-tained.The screening test of McAb showed:(1)Using immune enzymatic histochemistryfixed cell staining method all of 17 McAb reacted with astrocyte,(2) Using immuneenzymatic histochemistry viable cell staining method,eight of seventeen McAb react-ed with astrocyte.As to biological properties of McAb results were as follows:(1)Seven of eight McAb that showed positive reaction in viable staining assay have di-fferent degree of cytotoxicity to astrocyte,thymocyte and spleen cell in presence ofcomplement,one of eight has specific cytotoxicity only to astrocyte.(2) McAb(2C)possesses blocking effect on astrocyte,thymocyte and spleen cell proliferation respon-sive to various kind of mitogen.Furthmore,it has been found LPS may promote theproliferation of astrocytes and secreting interleukin 1(IL-1)-like substance This IL-1like substance seems to have a mutiple biological activities,i.e:(1)Thymocyte prolife-ration.(2) Fibroblast(L929 cell) proliferation and(3) Endogenous pyrogen activities.

Maximal oxygen uptake (VO2max) is an important indicator for cardiac function. This paper reviewed the VO2max and related index applied in the physical training.

Abstract On October 13 2023, the Beijing Economic and Technological Development Area Center for Disease Control and Prevention recAAAAAeived a report from a school indicating an outbreak of fever among students in Class 2, Grade 4. An on-site epidemiological investigation was immediately conducted. A total of 14 cases were reported, all of whom were students, with an attack rate of 34.15%. The onset of illness was concentrated between October 6 and 15, with the main clinical symptoms being fever, cough and fatigue. There were no cases of hospitalization, severe illness or death. Seven cases tested positive for Mycoplasma pneumoniae P1-Ⅱ. Based on the on-site investigation and laboratory test results, it was an outbreak of influenza-like illness caused by Mycoplasma pneumoniae infection. The likely cause of the spread was cases infecting other classmates through respiratory droplets while attending class. The outbreak occurred only in one class and did not spread to neighboring classes. Schools should actively carry out health education to raise awareness among parents for reporting infectious diseases, and strengthen morning and afternoon screenings to improve the sensitivity of identification.

BACKGROUND: To eliminate effectively and promptly sports fatigue and prevent excessive fatigue that are associate with the effects of training, improvement of sports results and health of athletes directly.OBJECTIVE:To explore the effects of acupoint iontophoresis on eliminating sports fatigue.DESIGN: Randomized controlled experiment was designed, in which, the athletes were taken as the objects.SETTING: Research and Teaching Room of Sport Medicine of Wuhan In stitute of Physical Education and College of Acupuncture and Massage of Shanghai University of Traditional Chinese Medicine.PARTICIPANTS:The experiment was performed in Wuhan Institute of Physical Education from June 2002 to June 2003. Totally 32 male athletes were selected as the objects,with similar level in training of kayak in Wuhan Institute of Physical Education. They were randomized into 5groups, named training group, training+ acupoint-dermal electric stimulation (dermal electric group), training + oral herbal administration (Chinese herb group), training + acupoint iontophoresis group (iontophoresis group)and training + Chinese herb + iontophoresis group(Chinese herb + iontophoresis group).There were 4 persons in the training control and 7 persons in the rest groups.METHODS:The experiment was performed in the training stage of large sports load in summer. The training methods were same in each group, totally for 8 weeks. ① Training group was taken as the control. ② In dermal electric group,after training,dermal electric stimulation was applied on shanzhong (CV 17), xinshu (BL 15), baihui (GV 20) and mingmen (GV 4).③ In Chinese herb group, after training, self-prepared shenwensan was applied for oral administration as decoction. ④ In iontophoresis group, after training, iontophoresis was used. ⑤ In Chinese herb + iontophoresis group,both self-prepared shenwensan and iontophoresis were applied.Trace observation of heart and lung functions were performed with subjective physical sensation scoring (before, after and on the 4th week of experiment), test of sports results,test of heart and lung functions and radioimmunoassay(RIA) (before and after experiment) in athletes.MAIN OUTCOME MEASURES: Subjective physical sensation scoring,test of sports results,test of heart and lung functions and determination of levels of endothelin (ET) and calcitoningene-related peptide (CGRP).RESULTS:The athletes in all of groups accomplished the training and tests of every index and the results had all entered final analysis.① Subjective sensation of athletes was all improved obviously and the effect of iontophoresis was improved significantly compared with dermal electric group and Chinese herb group (P ＜ 0.05). ② The results of rowing projects were improved to different extents in each group.The improved amplitude of 12 km training in every treating group was different significantly compared with training group (P ＜ 0.05). The result of 2 km training was improved most significantly in Chinese herb + iontophoresis group (P ＜ 0.05).③ VO2max was increased in Chinese herb group,iontophoresis group and Chinese herb + iontophoresis group to different extents. Maximal respiratory quotient (Rqmax)was in tendency of increasing in every group after experiment, HR-AT was all in tendency of decreasing and it was decreased in large amplitude in Chinese herb + iontophoresis group (P ＜ 0.05). The time of exhaustive sports was prolonged in all of groups,but the effect was the most obvious in iontophoresis group. ④ Endothelin (ET) was in tendency of increasing after experiment in each group, but the increasing amplitude was the largest in training group.The calcitoningene-relatedpeptide (CGRP) was in tendency of increasing in every group, but CGRP was increased with the best result in Chinese herb + iontophoresis group and that was with the least result in training group. The difference was no significant in comparisons among groups and before and after experiment(P ＞ 0.05).It was indicated that the training load of athletes had not reach the fatigue limitation.CONCLUSION:Cardiac sports fatigue is relevant to multiple factors.Acupoint iontophoresis can protect myocardium in multiple links and layers, improve cardiac function, reduce HR-AT, increase oxygenic endurance and promote the secretion of nervous peptide ET and CGRP; retard fatigue and promote fatigue elimination so as to delay cardiac sports fatigue.

Objective To investigate the correlation of CYP2D6 gene polymorphism and serum tamoxifen (TAM) and its active metabolites (4-hydroxy tamoxifen,4-OH-TAM) in terms of prognosis of breast cancer patients.Methods The oral mucosas and serum were obtained from 200 breast cancer patients receiving oral TAM from Jan 2008 to Oct 2010.Real-time RT-PCR was used to determine CYP2D6* 10 gene polymorphism.The relationship between CYP2D6* 10 gene polymorphism and clinicopathological features and prognosis was assessed by Chi-square test and Cox proportional model.Serum TAM and 4-OH-TAM concentration were determined by liquid chromatography-trap mass spectrometry (LC-MS).Results Of 200 breast cancer patients,CYP2D6 * 10/* 10 homozygotes were found in 94 cases (47％),CYP2D6 wt/wt wild type in 48 cases (24％) and CYP2D6 wt/* 10 heterozygote in 58 cases (29％).The concentration of serum 4-OH-TAM in patients with CYP2D6 wt/wt wild type and wt/* 10 heterozygote was significantly higher than that in patients with CYP2D6 * 10/ * 10 homozygote (F =4.31,P =0.01).CYP2D6 gene polymorphism was not related to clinicopathological features (P ＞ 0.05).Logrank test showed that patient's disease-free survival with mutational CYP2D6 (mean,47.2 months) was significantly shorter than that in patients without mutational CYP2D6 (mean,51.2 months) (P =0.018).Cox proportional model showed that CYP2D6 genotype was related to disease-free survival (HR =2.755,95％CI:1.230 ～6.173,P =0.014).Conclusions CYP2D6 *10/* 10 genotype is related to curative effect of TAM on breast cancer patients,detection of CYP2D6 * 10/* 10 genotype helps improve the choice of TAM therapy.

Objective To explore the electrode fixing method in children long-term electroencephalography and to improve the traditional method by combining with the pediatric characteristics and by means of clinical practice .Methods The pediatric subjects were given the appropriate preinstallation preparation ,then the double-layer elastic bandage combined with adhesive tape fixing method was adopted to fix the electrodes .Results The new method was generally accepted by children subjects ,the electrodes were easily to be installed and demounted without toxicity and residue ,the record diagram was better in quality .Conclusion Compared with the traditional method ,the improved electrode fixing method has the advantages of simplicity ,rapidness ,safety ,stability and humanization ,and is worth popularizing .