Sodium-glucose co-transportor 2(SGLT2)exerts an important role in the reabsorption of renal glucose,and SGLT2 inhibitors could reduce the blood glucose level in type 2 diabetes mellitus patients by decreasing renal glucose reabsorption and in-creasing urine glucose excretion. This paper briefly reviews the renal regulation of glucose homeostasis and the regulatory mechanism of SGLT2 inhibitors,then summarized the administration,clinical pharmacology,adverse reaction and other aspect of clinical applica-tion of three most representive SGLT2 inhibitors:dapagliflozin,canagliflozin and empagliflozin,in hope of providing reference for clinical use of SGLT2 inhibitors in the future.

Background Retinopathy of prematurity is mainly due to retinal neovascularization.Objective This laboratory work was to evaluate the efficacy of different dosage of avastin for inhibiting retinal neovascularization.Methods Ninety 7-day-old clean C57BL/J6 mice were randomized into six groups as follows:air control group,hyperxia control group,hyperxia BSS group and avastin groups.C57BL/J6 mice in air control group were raised in regular air environments.The fifty mice were fed under the environment with 75％ ±2％ oxygen for 5 days to establish the retinal neovascularization models.The 1.25,2.50 and 5.00 g/L avastin (0.5 μl) were injected inteavtreally in forty-five mice models as low,moderate and high dosage avastin groups respectively,and 0.5 μl BSS was used at the same way in fifteen models as hyperxia BSS group.The mice were sacrificed in the 17-day-old age using excessive anesthesia method and the retina sections were prepared for the calculation of the numbers of vascular endothelial cell nuclei broken retinal inner membrane after hemotoxylin and eosin staining.The expression of CD34 in the retina was detected by immunochemistry.The morphology and distribution of retinal neovascular vessel in various groups were observed using retinal flat.The use of the animals followed the Regulations for the Administration of Affairs Concerning Experimental Animals by State Science and Technology Commission.Results The numbers of cell nuclei broken the inner limiting membrane was significant increased in the hyperxia group compared with the air control group( P＜0.01 ),and those in difference doses of avastin were considerably reduced in comparison with hyperxia BSS group (P＜0.01) and hyperxia group (P＜0.01 ).The decrease of numbers of cell nuclei broken the inner limiting membrane was obvious in low dose of high dose of avastin compared with low dose of avastin (P＜0.05 ).CD34 was positively expressed in retina internal membrane of hyperxia group.Retinal flat revealed the regular distribution and normal structure of retinal vessels in air control group and avastin groups.However,retinal and vitreous cavity neovascularization,leakage and enlarged non-perfusion regions in the perimeter of the retina were seen in hyperxia group and hyperxia BSS group. Conclusions Intravitreal injection of avastin can arrest retinal angiogenesis in oxygen-induced retinal neovascularization models in a dose-dependent manner.

oy shows the highest cytotoxicity, and the leaching liquids of 5 different kinds of dental alloys may induce cell apoptosis through mitochondrion pathway.

ObjectiveTo investigate the alteration of MexB protein expression by plasmid containing siRNA template strand was transformed into Pseudomonas aeruginosa.Methods siRNA molecules specifically against mexB were designed and ligated into pGPU6/GFP/Neo vector to construct the recombinant plasmid pGPU6/GFP/Neo-siRNA.MexB gene was cloned into expression vector pET22b+ to construct plasmid pET22b+/mexB,the recombinant expression plasmid was transformed into E.coli BL21 (DE3)plysS and protein MexB was induced to express,then purified protein MexB was used to prepare specific antibodies in rabbits.The plasmids with siRNA molecules specifically against mexB were transformed into wild type strain,clinical multiresistant strain and mexB overexpression strain of Pseudomonas aeruginosa by electroporation respectively,and the changes of the expression of MexB were detected in 8,12,24 h respectively by Western blot.ResultspGPU6/GFP/Neo-siRNA was constructed successfully.Protein MexB was expressed successfully and the rabbit polyclonal antibodies against MexB was prepared well.The gene silence of mexB by siRNA molecules was effective in the three strains of Pseudomonas aeruginosa,but it depended on the silencing time.ConclusionThe expression of MexB was reduced in 8 h and 12 h,but in 24 h,the expression was unchanged.

Objective To investigate the effect of Panax notoginsenosides monomers ginsenoside Rg 1 in inhibiting hepatic fibro-sis .Methods The rat model of hepatic fibrosis was established by using 50% Ccl4 ,total 35 d .The different doses of Rg1was ad-ministered by hypodermical injection .At the end of the treatment ,the pathological changes of hepatic tissue were observed by light and transmission electron microscope .The stereological method was adopted to measure the volume density (Vvm) ,area density (Svm) ,specific surface(Qm) and surface number density (Nam) of liver cell mitochondria in various groups .Results The stereo-logical data of liver cell mitochondria showed that the statistical differences existed among various groups .Vvm in the Panax Notog-insenosides ,low dose Rg1 and isotonic saline groups were significantly increased compared with the normal control group with sta-tistical difference(P<0 .01);Vvm in the high dose Rg1 ,middle dose Rg1 and colchicine groups showed the increasing trend com-pared with the normal control group without statistical difference (P>0 .05);Vvm in the high ,middle and low dose Rg1 ,Panax No-toginsenosides and colchicine groups showed the decreasing trend compared with the isotonic saline group without statistical differ-ence(P>0 .05) .Svm in the low dose Rg1 ,Panax Notoginsenosides ,colchicine and isotonic saline groups were significantly increased compared with the normal group with statistical difference (P<0 .01);Svm in the high dose Rg1 ,middle dose Rg1 ,Panax Notogin-senosides and colchicine groups was significantly induced compared with the isotonic saline group with statistical difference (P<0 .01);Svm in the high dose Rg1 was reduced compared with the middle dose Rg1 group(P<0 .05) .Nam in the low dose Rg1 ,col-chicine and isotonic saline group was significantly increased compared with the normal group (P<0 .01);Nam in the high dose Rg1 , middle dose Rg1 and Panax Notoginsenosides groups were significantly reduced compared with the isotonic saline group with statis-tical difference(P<0 .01);Nam in the high dose Rg1 group was reduced compared with the middle dose Rg 1 group with statistical difference (P<0 .05) .Qm in all groups was reduced compared with normal group without statistical difference (P>0 .05) .Conclu-sion Rg1 has antifibrosis effects of Panax notoginsenosides ,even exceeds Panax notoginsenosides in some aspects ,and the above-mentioned effect is positively correlated with dose .Rg1 is an ideal drug for preventing and treating liver fibrosis .

OBJECTIVETo study the effect of dihydroartemisinin (DHA) combined irradiation on the apoptosis of human lung cancer GLC-82 cells and to study its mechanism.

METHODSThe growth inhibition rate of GLC-82 cells acted by different concentrations DHA was detected using MTT assay at 24, 48, and 72 h, respectively. Clone forming test was used. With multi-target single-hit model, the radiosensitization effect was assessed by calculating sensitizing enhancement ratio (SER).The effect of DHA combined irradiation on the apoptosis of GLC-82 cell cycle distribution and apoptosis were measured by flow cytometry. The protein expression of p53, p21, Bcl-2, and Bax were detected by Western blot.

RESULTSDifferent concentrations DHA (4, 8, 16, 32, 64, and 128 μg/mL) had cytotoxicity on GLC-82 cells. The IC50 for 24, 48, and 72 h was 38.25,20.58, and 10.36 μg/mL, respectively, in obvious dose- and time-dependent manner. The growth inhibition rate was more significantly increased than that of the blank control group (P < 0.01, P<0.05). DHA had sensitization enhancement effect on GLC-82 cells, with SER of 1.4. DHA combined irradiation could obviously change the structure of GLC-82 cells cell cycle and induce apoptosis (with the apoptosis rate of 21.5%), which was significantly different from that of the blank control group (P < 0.05). Western blot showed the expression of p53 and p21 protein could be increased by DHA combined irradiation, and the expression of Bcl-2 protein down-regulated (P <0.01, P <0. 05).

CONCLUSIONSDHA had stronger cytotoxicity and radiosensitization on GLC-82 cells. Its mechanisms might lie in making the arrest of GLC-82 cells' growth at G0/G1 phase, decreasing the ratio of cells at S phase, restoring the function of p53, decreasing the expression of Bcl-2 protein, and inducing apoptosis in GLC-82 cells.

Apoptosis ; drug effects ; Artemisinins ; pharmacology ; Cell Cycle ; drug effects ; Cell Proliferation ; drug effects ; Down-Regulation ; drug effects ; Flow Cytometry ; Humans ; Lung Neoplasms ; metabolism ; Neoplasm Proteins ; metabolism ; Radiation-Sensitizing Agents ; pharmacology ; Tumor Cells, Cultured ; bcl-2-Associated X Protein ; metabolism

Objective:To investigate the additional value of unenhanced computed tomography (CT) in the differential diagnosis of brain tumors and non-neoplastic lesions.Methods:A total of 237 cases [140 males and 97 females; (49±16) years old; including 48 cases of low-grade glioma, 134 cases of high-grade glioma, 38 cases of primary central nervous system lymphoma, 9 cases of medulloblastoma, 5 cases of germinoma, and 3 cases of central neurocytoma] of brain tumors (diffuse gliomas and non-glial tumors) diagnosed by biopsy or surgery and pathology in the Affiliated Hospital of Qingdao University from September 2016 to October 2020 were collected retrospectively. Sixty-six cases [46 males and 20 females; (42±13) years old; including 12 cases of abscesses, 5 cases of infarcts, 33 cases of demyelinating lesions, 11 cases of autoimmune encephalitis, and 5 cases of central nervous system vasculitis] of brain non-neoplastic lesions were confirmed by biopsy or clinic. All patients underwent routine magnetic resonance imaging (MRI) scan and unenhanced CT before the treatment. The images were reviewed by two neuroradiologists together blind to the final diagnosis with and without CT images respectively. The diagnostic results and reliability scores were recorded, and the accuracy of the two evaluations was compared.Results:CT hyperattenuation exhibited a higher specificity (95%) than conventional MRI scan (86%), and a lower diagnostic sensitivity (34% vs 86%). Compared to MRI alone, the combined modality of MRI and unenhanced CT significantly improved diagnostic accuracy (94% vs 86%). Additionally, the CT attenuation ratio of non-neoplastic lesions was significantly lower than that of neoplastic lesions [0.69 (0.61,0.78) and 1.14 (1.00,1.25), W=2 123, P<0.05]. The CT attenuation ratio in the non-glial origin tumor group was significantly higher than that in the diffuse glioma group [1.28 (1.18,1.41) and 1.13 (0.97,1.21), W=1 858, P<0.05]. There was no significant difference in grade Ⅲ and Ⅳ groups of diffuse glioma [1.11 (0.99,1.20) vs 1.16 (1.09,1.24), P>0.05 (Nemenyi test)]. However, both were significantly higher than that of grade Ⅱgroup of diffuse glioma [0.89 (0.76,1.07), P<0.05 (Nemenyi test)]. No significant difference was observed between astrocytic tumors and oligodendroglial tumors at the same grade. Conclusions:Hyperattenuation on unenhanced CT is highly specific for the diagnosis of brain tumors. Unenhanced CT plus MRI is more accurate for distinguishing the two entities in hypoattenuation lesion on unenhanced CT.

Objective To discuss the anatomic features, clinical presentations, diagnosis,differentiations and treatments of congenital fourth branchial anomaly(CFBA). Methods The clinical data of 8 patients with CFBA were retrospectively analyzed. Results Of the 8 patients aging from 27 to 300 months(median age: 114 months), 4 male and 4 female; 3 untreated previously and 5 recurrent. All lesions, including 1 cyst, 3 sinus (with internal opening) and 4 fistula, located in the left necks. Three patients presented acute suppurative thyroiditis, 4 deep neck abscesses, and 1 neck lump. Preoperative examinations included barium esophagogram, direct laryngoscopy, ultrasonography, CT, MRI, and so on.The principles of managements were adequate drainage, infection control during acute period and radical surgery during quiescent period. Classic surgical approach consisted of complete excision of branchial lesions, dissection of recurrent laryngeal nerve and partial thyroidectomy. Selective neck dissection was applied in recurrent cases to extirpate branchial lesions, scarrings and inflammatory granuloma.Postoperatively, 1 case was with local incision infection which healed by wound care; 1 case was with temporary vocal cord paralysis which completely recovered 1 month after operation. No recurrence was found in all of 8 cases with follow-up of 13 to 42 months (median: 21 months). Conclusions CFBA relates closely anatomically with recurrent laryngeal nerve and thyroid grand. The barium esophagogram and direct laryngoscopy are the most useful diagnostic tools. CT and MRI are all beneficial to the diagnosis of CFBA.The treatment key to CFBA is the complete excision of lesion during a quiescent period after inflammatory control, together with the dissection of recurrent laryngeal nerve ,partial thyroidectomy and partial resection of lamina of thyroid cartilage (if necessary), which all can decrease the risk of complications and recurrence.For recurrent cases, selective neck dissection is a safe and effective surgical procedure.

Objective:To evaluate the value of transesophageal echocardiography(TEE)in postoperative low cardiac output syndrome of critical cardiac valvular disease.Methods:The preoperative data of 16 patients with critical cardiac valvular disease who suffered from postoperative low cardiac output syndrome,as well as the postoperative treatment of them,was retrospec-tively analyzed.Results:Among the 16 patients,9 cases underwent intra-aortic balloon pump(IABP)support suggested by TEE.And 7 of the 9 patients recovered without complications,while the other 2 patients died.IABP were not suggested by TEE in 7 patients,2 of whom underwent exploratory thoractomy,while the other 5 patients recovered after adjustment of vas-opressor agents and improvement of internal environment.Conclusions:TEE can be used in the differentiation of the cause of postoperative low cardiac output syndrome in patients with critical cardiac valvular disease and it can provides the basis for the reasonable application of IABP.

OBJECTIVETo investigate clinicopathological characteristics and the pattern of lymph node metastasis of patients with gastric remnant cancer.

METHODSThe data of the clinicopathological characteristics and the pattern of lymph node metastasis in 56 patients with gastric remnant cancer treated from March 1994 to December 2008 was investigated and compared with those in 1171 patients with primary gastric cancer treated over the same period.

RESULTSFifty-six patients (4.6%) with gastric remnant cancer were enrolled in this study during the period. Compared with patients with primary gastric cancer, the age of cancer onset was older [(64.3+/-9.0) vs. (58.3+/-12.6) yrs], lymph node metastasis rate was higher (31.8% vs. 25.5%), Borrmann's classification was later and neighbor organ resection rate was higher (57.1% vs. 26.4%) in patients with gastric remnant cancer; the differences were all significant (chi2=18.800, 11.679, 9.177, 25.190; P<0.05). Patients with gastric remnant cancer who underwent lymph node dissection tended to have a higher incidence of No.10 (splenic hilar lymph node) and No.11 (splenic artery lymph node) group lymph node metastasis than those in primary gastric cancer (chi2=5.558, 6.099; P<0.05). In contrast, patients with primary gastric cancer had a higher incidence of No. 2 (left cardiac lymph node), No.3 (lesser curvature lymph node) and No.8 (common hepatic artery lymph node) group lymph node metastasis than those in gastric remnant cancer (chi2=15.508, 6.003, 4.084; P<0.05). The jejunal mesentery lymph node metastasis was 24.0% (6/25) in patients with gastric remnant cancer and the peripheral connective tissue infiltration rate was 14.3% (8/56).

CONCLUSIONSIt suggested that patients with gastric remnant cancer has different clinicopathologic characteristics and the pattern of lymph node metastasis from those with primary gastric cancer. D2 lymph node dissection of proximate gastric cancer and jejunal mesentery lymph node dissection should be the standard operation for these patients; but combined neighboring organ resection should be taken into consideration.

Age of Onset ; Aged ; Female ; Gastric Stump ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; pathology ; Male ; Middle Aged ; Stomach Neoplasms ; pathology ; surgery