Recent preclinical data have demonstrated that antidiabetic drug metformin can act as an anticancer agent for breast cancer.Epidemiologic evidences show that metformin decreases the incidence of breast cancer and cancer-related mortality in diabetic patients.The metformin treatment also increases complete pathological tumor response rates following neoadjuvant chemotherapy for breast cancer patients.Metformin also displays significant growth inhibitory effects in most types of breast cancer cell lines and tumor xenogra-fts in mice.Preclinical data also shows metformin combined with chemotherapy drugs or HER2-targeted drugs or new anticancer drugs has synergic anti-cancer effect.Reduction of the insulin/insulin-like growth factor signaling pathway in body and activation of LKB1/AMPK and inhibition of downstream mTOR pathway in tumor cells have been found to play the most important role in anti-cancer effect of metformin.Currently,a number of clinical trials are underway in breast cancer patients to evaluate the effective use value of metformin as a cancer therapy

Objective:To observe clinical therapeutic effect and mechanisms of acupuncture at Xi Xue(cleft points) combined with injection of Chinese medicine for treatment of 30 cases of lumbar intervertebral disc prolapse of blood stasis type.Methods:60 cases were randomly divided into a treatment group and a control group,30 cases in each.Patients of the treatment group were treated with acupuncture at L4-S1 Jiaji points(EX-B_2),Waiqiu(GB 36),Weizhong(BL 40),Xiaxi(GB 43),combined with injection of Puerarin Injectio,and the control group were given routine acupuncture combined with injection of Puerarin Injectio into Ashi points.Changes of interleukin-6(IL-6) and hemorheologic indexes before and after treatment were investigated in the two groups.Results:In the treatment group,total therapeutic effect was significantly superior to(P

[ Objective ] To observe the therapeutic effect of acupuncture on cleft acupoints combined with puerarin intervention for the treatment of prolapse of lumbar intervertebral disc with blood stasis. [ Methods ] Sixty cases were divided into two groups by using random number: group A (n = 30) was treated by acupuncturing the Jiaji points from 4th lumbar vertebrae to 1st sacral vertebrae and specific points such as Waiqiu (GB36), Weizhong (BL40) and Xiaxi (GB43), and with intervention of puerarin Injection into the region of affected lumbar intervertebral foramen; group B (n = 30) was treated by acupuncturing the same acupoints as group A and with routine acupoint injection of puerarin Injection. After a 30-day treatment , the therapeutic effect in the two groups was evaluated by symptoms and signs scoring and pain visual stimulation scoring method. Peripheral blood interleukin 6 (IL-6) and blood rheology parameters before and after treatment were also observed to investigate the therapeutic mechanism. [Results] After one treatment course, the therapeutic effect in group A was better than that in group B (Z = 2.525, P = 0.012) and the mean treatment course was shorter (P 0.05). [Conclusion] The synergistic action of acupuncture combined with puerarin intervention for the treatment of prolapse of lumbar intervertebral disc with blood stasis is better than that of routine acupoint injection of puerarin Injection. The mechanism may be related to the fact that intervention treatment can introduce the drug to the affected area, which benefits the improvement of peripheral blood IL-6 and blood rheology parameters, and thus relieve radiculitis.

In recent years,antiviral therapy for chronic hepatitis B infected patients has achieved great development along with the invention of nucleos (t) ide,nucleos (t) ide analogues,interferon α and pegylated interferon α.The development of antiviral medicine also proposes new demands for the clinical diagnosis and therefore promotes the development of laboratory diagnostic techniques in the detection of chronic hepatitis B.In this review,we focused on the clinical application in the quantitive detection of HBV DNA,and its significance on clinical evaluation,treatment options,follow-up and prognosis in antiviral therapy.

Objective To study the relationship between hyperhomocysteinemia and intracranial and extracranial vascular stenosis in patients with ischemic cerebrovascular disease.Methods 405 patients with ischemic cerebrovascular disease were chosen to detect their serum homocysteine(Hcy) concentrations using automatic biochemical analyzer by enzymatic cycle detection,and the levels of serum folate and Vitamin B12 were detected .The intracranial vascular were detected by Transcranial Doppler, and the extracranial vascular were detected by Color Doppler. The internal carotid arteries(ICA) were classified as normal, mild stenosis(95%). Results Mean serum Hcy concentrations were significantly higher in patients with stenosis of intracranial or (and) extracranial vascular than that in the patients with no arterial stenosis (P0.05). The serum Hcy concentrations were different significantly in patients with different severities of the ICA stenosis and the MCA stenosis (all P0.05). The serum Hcy concentrations were positive correlation with severities of the ICA stenosis and the MCA stenosis(r=0.356, P

Objective To discuss the opportunity of transurethral resection of prostate (TURP) after transrectal prostate biopsy.Methods We analyzed 60 cases of benign prostatic hyperplasia(BPH) who underwent TURP after transrectal prostate biopsy from September 2013 to September 2015.All the patients were divided into either group A or group B in chronological order, with 30 cases in each group.There were no significant differences in age, prostate specific antigen (PSA), prostate volume, hemoglobin level, and international prostate symptom score (IPSS) between the two groups.The group A and group B were treated by TURP at 1 week and 4 weeks after transrectal prostate biopsy, respectively.The parameters including operation time, excised prostate weight, intraoperative total blood loss, bladder irrigation time, and IPSS at 3 months after operation were recorded.Results The operation time, intraoperative total blood loss, bladder irrigation time, and IPSS in the group B were significantly lower than those in the group A [(58.3±6.0) min vs.(62.0±3.3) min, t=2.952, P=0.005;(154.1±15.8) ml vs.(167.4±29.5) ml, t=2.181, P=0.035;(19.2±0.8) h vs.(20.6±2.3) h, t=3.034, P=0.004;(18.3±2.5) points vs.(20.3±2.0) points, t=3.419, P=0.001].The excised prostate weight in the group B was significantly higher than that in the group A [(37.1±4.0) g vs.(33.3±7.8) g, t=-2.341, P=0.024].Conclusions TURP performed at 4 weeks after transrectal prostate biopsy can significantly increase the excised prostate weight, reduce intraoperative total blood loss volume, shorten the operation time and postoperative bladder irrigation time, and improve urinary symptoms.In brief, we recommend that TURP be executed at 4 weeks after transrectal prostate biopsy.

Objective To explore the effect of humanistic care on quality of life and self-efficacy of diabetic patients. Methods According to the principle of convenience sampling, 135 patients with diabetes mellitus from January 2016 to June 2016 were randomly divided into two groups according to the random number table method. The patients in the observation group were treated with fishbone analysis to analyze the quality of life and the self-efficacy, and the patients were given humanistic nursing care. The patients in the control group were treated with routine diabetes care. After 6 months of care, the quality of life and self-efficacy were analyzed between the two groups. Results After treatment, the quality of life scores in the observation group (50.33 ± 3.02, 30.55 ± 2.03, 17.20 ± 2.01, 12.35 ± 0.87) were significantly higher than those in the control group (41.57 ± 3.46, 23.60±2.17,13.55±2.34, 9.02±0.64) , the difference between the two groups was statistically significant (t=8.112-21.137, all P <0.01); The score of self-efficacy in the observation group (30.52 ± 2.33) was significantly higher than that in the control group (24.69 ± 1.98), the difference between the two groups was statistically significant (t=13.072, P<0.01). Conclusions Humanistic care can significantly improve the quality of life and self-efficacy of patients with diabetes mellitus. The application of the nursing model in patients with diabetes has significant effect, which is worthy of clinical application.

Objective: To observe changes of variation of red blood cell distribution width-coefficient (RDW-CV), levels of matrix metalloproteinase (MMP)-2, MMP-9 and tissue inhibitor of metalloproteinases (TIMP)-1 in patients with essential hypertension (EH) of different risk stratification.Methods: A total of 105 EH patients treated in our department from Oct 2015 to Sep 2016 were regarded as EH group.According to hypertension risk stratification, they were divided into low risk group (n=34), medium risk group (n=38) and high-and extremely high risk group (n=33).Another 105 subjects with corresponding age and gender were selected as healthy control group during the same period.RDW-CV, serum levels of MMP-2, MMP-9 and TIMP-1 were measured and compared among all groups.Multivariate Logistic regression analysis was used to analyze relationship among above indexes and hypertension.Results: Compared with healthy control group, there were significant rise in RDW-CV [(12.57±1.46) vs.(14.54±1.82)], serum levels of MMP-2 [(121.71±18.86)ng/ml vs.(155.43±40.81)ng/ml], MMP-9 [(109.72±21.80)ng/ml vs.(191.23±53.05)ng/ml] and TIMP-1 [(59.42±9.41)ng/ml vs.(83.64±15.82)ng/ml] in EH group, P<0.05 or <0.01.Compared with low risk group, there were significant rise in RDW-CV [(13.35±1.54) vs.(14.43±1.17) vs.(15.90±1.81)], serum levels of MMP-2 [(131.21±35.24) ng/ml vs.(152.16±33.15)ng/ml vs.(184.16±37.14)ng/ml], MMP-9 [(163.95±38.61) ng/ml vs.(198.70±43.52)ng/ml vs.(232.83±54.12)ng/ml] and TIMP-1 [(73.15±13.12)ng/ml vs.(83.78±10.22) ng/ml vs.(94.27±16.77)ng/ml] in medium risk group, high-and extremely high risk group, and those of high-and extremely high risk group were significantly higher than those of medium risk group, P<0.05 or <0.01.Multivariate Logistic regression analysis indicated that RDW-CV, MMP-2, MMP-9 and TIMP-1 were independent risk factors for hypertension (OR=2.248~2.725, P<0.05 or <0.01).Conclusion: RDW-CV,MMP-2,MMP-9 and TIMP-1 are independent risk factors for hypertension, active monitoring and intervention should be given for these risk factors.

OBJECTIVE:To observe the clinical effect of Shenqi Fuzheng injec tion combined with chemotherapy in treatment of advanced lung cancer.METHODS:67patients were randomly divided into chemotherapy combined+Shenqi Fuzheng injection therapy group(trial group,TG)and simple chemotherapy group(control group,CG ).RESULTS:The efficacy rates in TG and CG were57.14%and31.25%respectively,there was significant difference between the2groups(P

Objective The purpose of this study was to evaluate the perioperative management of patients with recent myocardial infarction (MI) undergoing non-cardiac surgery.Methods Twelve patients underwent general or thoracic surgery on the 72th to 175th day after acute MI. Their mean age was (67?4 ) years old. All patients received epidural block or epidural block combined with general anesthesia. Epidural catheter was left in place for postoperative analgesia.Results All patients underwent operation smoothly. During operation ECG monitoring showed no ischemic ST-T changes. Postoperative pain relif was satisfactory. No acute heart failure or myocardial reinfarction occurred during their stay in hospital.Conclusions In patients who had recent MI the time interval between the first MI and surgery should not be the only factor in the risk assessment. Other factors such as urgency of surgery, the severity of coronary artery disease, exercise tolerance and complexity of surgery should also be considered. Adequate preoperative evaluation and preparation and maintenance of cardiac function during perioperative period are crucial to the safety of surgery. Epidural block combined with general anesthesia is the anesthesia of choice for patient with recent MI undergoing non-cardiac surgery.