Objective To investigate the clinical efficacy and safety of sitagliptin combined with metformin in treating patients with type 2 diabetes with non-alcoholic fatty liver diease (NAFLD).Methods Sixty-five patients with type 2 diabetes with non-alcoholic fatty liver admitted into our hospital from June 2012 to June 2015 were randomly divided into two groups.Thirty-three patients in control group were treated with metformin only,and thirty-two patients in observation were treated with sitagliptin combined with metformin.The changes in body mass index (BMI),fasting plasma glucose (FPG),2-hour postprandial glucose (2hPG),Hemoglobin Ale (HbAlc),homeostasis model assessment of insulin resistance (HOMA-IR),and liver function index including that aminopherase of alanine acid (ALT),aminopherase of aspartic acid (AST),gamma-glutamyl transterase (GGT),triglyceride (TG),and total cholesterol (TC) were detected before and after 16 weeks of treatment.And the total effective rate and safety were analyzed and compared.Results After treatment,HOMA-IR,FPG,2hPG,HbA1c,ALT,AST,GGT,TG,and TC were remarkable improvement (P ＜ 0.05),and HOMA-IR,HbA1c,AST,ALT,GGT,and TG were significantly better than those of control (P ＜ 0.05).Additionally,the total effective rate in observation group with 90.9％ was significantly higher than that of control group with 42.4％ (P ＜ 0.05).And difference in incidences of adverse effect between observation group with 15.6％ and control group with 9.1％ were not significant.Conclusion Sitagliptin combined with metformin treatment had a good ability on treating patients with type 2 diabetes with NAFLD by improvement of metabolic syndrome and liver function.

Objective To investigate the expression of Smad5 gene in the cochlea and to identify its location. Methods Reverse transcription polymerase chain reaction (RT-PCR) was employed to detect the expression of Smad5, the in situ hybridization and the immunohistochemical technique were used to localize the Smad5 messenger RNA and the Smad5 protein in mouse cochlea. Results Smad5 gene expressed in cochlea at a high level. Smad5 expression was concentrated in supporting cell, hair cell, spiral ganglion, epithelium of stria vascularis and basilar membrane. Conclusion The Smad5 proteins exist in the mouse cochlea and it may be involved in the cochlear formation and the differentiation of hair cell. Smad5 might be an essential factor for the development of normal cochlea.

Objective To investigate the possible role of leukocytes, a important cellular component of the blood, in the induction of microcirculatory disturbances in noise-exposed cochleae. Methods Guinea pigs were exposed to a 4 kHz narrow band noise at 115 dB SPL for 4 hours, and the exposed cochleae were collected at 2 or 4 days after the noise exposure. Several techniques (cell viability assay, fluorescent labeling for blood plasma and for hair cell nuclei) were used to examine morphological changes in microvessels in the spiral lamina and in the stria vascularis as well as the hair cell nuclei. Results In noise-exposed cochleae, aggregatad leukocytes were found in the vessels of the spiral lamina. In the up-stream of the vessels with aggregated leukocytes, red blood cells were tightly packed, causing an increase in vessel diameters. Most leukocytes were located within the lumen of vessels, but some of them infiltrated the spiral lamina, usually alongside the vessels. Cell viability, assessed by trypan blue staining, showed that these plugged leukocytes lost their viability. In contrast, no leukocytes aggregated in the vessels of the stria vascularis, nor did leukocytes lose their viability. Conclusion In the cochleae exposed to intense noise, leukocytes were trapped in the vessels of the spiral lamina, leading to disturbance of blood flow. The involvement of leukocytes in local damaging processes and the fate of leukocytes need further studies.

To observe the morphological changes in hair cell nuclei in guinea pigs following noise exposure, guinea pigs were exposed to 4 kHz narrow band noise at 115 dB SPL for 4h. The cochleae were collected for the examination of the hair cell nuclei 14 days after the noise exposure. A fluorescent dye, Hoechst 33342,a fluorescent dye, was used to label the nuclear DNA and the specimens were examined under a fluorescence microscope for quantitative assessment of hair cell nuclear damage. There were three types of morphological changes in the damaged hair cell nuclei: nuclear swelling, nuclear condensation (karyopyknosis) and nuclear missing. Nuclear swelling was more frequent than nuclear missing. Nuclear condensation was less frequently found. The results suggested that complicated, long term and non synchronous biological processes might be involved in noise induced hair cell damage. A large number of hair cells with swollen nuclei, which might recover afte wards,still could be seen in the cochlea two weeks after noice exposure.

Child ; Humans ; Laryngeal Diseases ; pathology ; therapy ; Vocal Cords ; pathology

Objective To evaluate the clinical safety and efficacy of Cheatham-Platinum(CP)covered stent in treatment of aortic coarctation.Methods The therapeutic efficacy was retrospectively analyzed in 15 patients with aortic coarctation who were treated by BIB balloon dilation and CP covered stent implantation.Results All patients were well recovered,the stent did not appear displaced,folded,aorta dissection and rupture.The pressure difference was 5-10 mm Hg(1 mm Hg=0.133 kPa)between proximal part and distal end after operation.Following up(20±12)months,the therapy efficacy of all the patients was stable and there was no fracture,removal,aortic stenosis or dysarteriotony.Heart ultrasounds demonstrated good close of the cases with patent ductus arteriosus.Conclusion CP covered stent is a safe and available clinical therapy,featured by minimum aorta injuries.

Adolescent ; Adult ; Boron ; adverse effects ; Humans ; Male ; Occupational Exposure ; Sperm Count ; Sperm Motility ; drug effects ; Spermatozoa ; drug effects

Objective To explore the clinical value of transvaginal three-dimensional color Doppler ultrasound in assessing effects of Chinese herbal drugs on improving endometrial receptivity in patients with thin endometrium.Methods A total of 76 cases of patients diagnosed with thin endometrium in Jiangbei District Hospital of Traditional Chinese Medicine from June 2015 to October 2016 were selected and treated with Chinese herbal prescription for three months.The endometrial thickness,endometrial volume and blood flow indexes before and after treatment were measured by using transvaginal three-dimensional color Doppler ultrasound.Results After 3 months treatment,the endometrial thickness and endometrial volume were increased,and the pulse index (PI) and resistance index (RI) of endometrial blood flow were decreased,compared with those before treatment,there were statistically significant differences(P＜0.05).The results of three-dimensional color Doppler ultrasound indicates that after 3 months treatment the vascularization index (VI),flow index (FI) and vascularization flow index (VFI) were significantly higher than those before treatment,there were statistically significant differences (P＜0.05).Conclusion The Chinese herbal prescription could increase the thickness and volume of endometrium,augment blood supply,and improve endometrial receptivity significantly.Transvaginal color three-dimensional Doppler ultrasound is a convenient and objective method for evaluating clinical efficacy of Chinese herbal prescription in patients with thin endometrium,which has high practical value.

OBJECTIVETo invesitigate the clinical effects of percutaneous closed reduction and cannulated screw internal fixation combined with external fixation in the treatment of unstable pelvic fractures.

METHODSFrom April 2006 to May 2009,29 patients with pelvic fractures of rotatory instability were treated with closed reduction and screw internal fixation combined with external fixation. There were 19 males and 10 females with an average age of 31 years old (ranged from 19 to 53 years). Based on the Tile classification,17 cases were type CI and 12 case were type C2. Tornetta standard and Majeed score were used to evaluated the clinical effect after operation.

RESULTSAll patients were followed up from 10 to 24 months with an average of 16 months. There were no nerve injuries and other organ injuries, only one case of infection was found and it was cured with wound dressing. Time of fracture union was from 14 to 18 weeks with the mean of 16.2 weeks. No loosening, slippage or breakage of the screw were found. According to the Tornetta standards,14 cases obtained excellent results, 10 good, 4 fair and 1 poor. The Majeed score was 87.2 ± 11.3, 16 cases got excellent results, 9 good and 4 fair.

CONCLUSIONClosed reduction and screw internal fixation combined with external fixation is an effective way to treat unstable pelvic fractures with Tile type C1 and Tile type C2.

Adolescent ; Adult ; Child ; External Fixators ; Female ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Pelvic Bones ; injuries ; surgery

OBJECTIVE To investigate the effect of Hath1 on epithelial ridge (GER) cells from postnatal rat cochlear. METHODS An experimental method was developed which allowed the isolation and culture of GER cells from P1 rat cochleae using a combinatorial approach of enzymatic digestion and mechanical separation. The dissociated GER cells were cultured in DMEM+10% FBS. The GER explants infected with ad-Hath1 for 3 hours were cultured for 10 days and observed under scanning electron microscope. RESULTS The GER cell cultures tended to attach to the substratum and grow in patches which assume a polygonal morphology similar to that of epithelial cells in medium containing 10% serum. Stereociliary bundle-like structures were observed in the boundary of GER cell patches forced to express Hath1. CONCLUSION That GER cells which are likely hair cell progenitors could be cultured in vitro and generate stereociliary bundle-like structure when forced to express Hath1 suggests that the misexpression of Hath1 probably can induce the predifferentiation of pure hair cell progenitors into hair cells in vitro.