Glioblastoma multiforme (GBM) in the central nervous system is the most lethal advanced glioma and currently there is no effective treatment for it. Studies of sinomenine, an alkaloid from the Chinese medicinal plant,

Objective: To effectively reduce the concentration of poisons in cleanroom, protect the health of workers, realize the optimization and automatic control of the new return air device. And the influence of initial concentration, air volume, temperature and relative humidity of formaldehyde on the purification effect of the new return air device was explored. Methods: The purification effect of the new return air device installed with the activated carbon and the photocatalyst purification net or ordinary activated carbon purification network was tested in a 60 m³ simulated cleanroom. The concentration of formaldehyde was determined by solution absorption-phenol reagent spectrophotometry. Based on the single factor experiment to determine the combination of two purification nets. The effects of air volume, initial formaldehyde concentration, temperature and relative humidity on the purification effect of the new return air device were investigated by orthogonal test. Then, the performance parameters of the return air device to purify formaldehyde were determined. Results: The formaldehyde purification efficiency of the two types of purification nets in the new return air device was higher than that of the ordinary activated carbon purification network (P<0.05) . The combination of activated carbon and photocatalyst purification net has no effect on the formaldehyde purification efficiency of the return air device (P>0.05) . According to the direct analysis and variance analysis, air volume was the most sensitive factor (F value is 18.894, P<0.05) , followed by initial concentration (F value is 16.128, P<0.05) , while temperature and relative humidity have little effect (F value is 0.041 and 0.599, respectively, P>0.05) . LSD analysis showed that there was no significant difference in the purification efficiency of formaldehyde between 475 m³/h and 626 m³/h (P>0.05) . From the perspective of formaldehyde purification efficiency and energy saving, when the air volume is set to 475 m³/h, the new return air device has higher purification efficiency for high concentration of formaldehyde. Conclusion The new return air device consisting of activated carbon and photocatalyst purification net can play a good purification role in cleanroom with different temperatures and different humidity. Its formaldehyde purification efficiency is affected by air volume and initial concentration.

Objective To compare the safety and efficacy of insulin degludec (IDeg) with those of insulin glargine (IGlar) in insulin-naive subjects with type 2 diabetes (T2DM).Methods This was a 26-week,randomized,open-label,parallel-group,treat-to-target trial in 560 Chinese subjects with T2DM (men/women:274/263,mean age 56 years,mean diabetes duration 7 years) inadequately controlled on oral antidiabetic drugs (OADs).Subjects were randomized 2:1 to once-daily IDeg (373 subjects) or IGlar(187 subjects),both in combination with metformin.The primary endpoint was changes from baseline in glycosylated hemoglobin(HbA1c) after 26 weeks.Results Mean HbA1c decreased from 8.2％ in both groups to 6.9％ in IDeg and 7.0％ in IGlar,respectively.Estimated treatment difference (ETD) of IDegIGlar in change from baseline was-0.10％ points (95％ CI-0.25-0.05).The proportion of subjects achieving HbA1c ＜ 7.0％ was 56.3％ and 49.7％ with IDeg and IGlar,respectively [estimated odds ratio of IDeg/IGlar:1.26 (95 ％ CI 0.88-1.82)].Numerically lower rateof overall confirmed hypoglycaemia and statistically significantly lower nocturnal confirmed hypoglycemia were associated with IDeg compared with IGlar,respectively [estimated rateratio of IDeg/IGlar 0.69 (95％ CI 0.46-1.03),and 0.43 (95％ CI 0.19-0.97)].No differences in other safety parameters were found between the two groups.Conclusions IDeg was non-inferior to IGlar in terms of glycaemic control,and was associated with a statistically significantly lower rate of nocturnal confirmed hypoglycaemia.IDeg is considered to be suitable for initiating insulin therapy in Chinese T2DM patients on OADs requiring intensified treatment.Clinical trail registration Clinicaltrials.gov,NCT01849289.

T2DM+LIRA group and T2DM+LIRA+UC-MSCs group (P<0. 05). The ratio of insulin positive area in pancreas tissue was obviously rised, while the ratio of glucagon positive area in pancreas tissue was clearly descended in T2DM+LIRA+UC-MSCs group. And the same difference in valuating islet cells apoptosis by TUNEL could be observed ( P<0. 05). The expression of NF-κB and TLR4 protein in pancreas tissue of T2DM+LIRA+UC-MSCs group were the least amongthefourgroups[(0.75±0.10)vs(0.60±0.08),(0.47±0.08),(0.31±0.04),P<0.05]and[(1.24± 0. 12) vs (0. 93 ± 0. 10), (0. 95 ± 0. 09), (0. 74 ± 0. 07), P<0. 05 ]. Conclusion The combined treatment of liraglutide with umbilical cord mesenchymal stem cells is superior over a single treatment of liraglutide or umbilical cord mesenchymal stem cells in improving the islet function in type 2 diabetes mellitus models, which may be related to the down modulating the TLR4/NF-κB inflammatory signaling pathway.

Objective To investigate the effect of liraglutide combined with bone marrow mesenchymal stem cells (BM-MSCs) on glucose metabolism in experimental type 1 diabetic (T1DM) rats.Methods T1 DM rats were established by injecting 60 mg/kg streptozotocin.According to random number table,they were divided into T1DM group (n =10),BM-MSCs group (n =10),LIRA group (n =10),and LIRA+BM-MSCs group (n =10),and were treated for 8 weeks respectively.Random blood glucose,24 h urine volume and protein excretion were tested.Serum concentrations of insulin,C-peptide,glucagon,gastrin,cholecystokinin,and glucagon-like peptid 1 (GLP-1) were assayed by ELISA.Expressions of insulin and glucagon in pancreas were measured by immunohistochemistry.Results After 8 weeks,the levels of random blood glucose,HbA1C,24 h urine volume and 24 h urinary protein excretion in group 4 were significantly decreased compared to the other three groups (P＜0.05).Compared to T1DM group and BM-MSCs group,the levels of insulin,C-peptide,gastrin,cholecystokinin and GLP-1 in LIRA+BM-MSCs group were significantly increased,while glucagon was decreased (P＜0.05).Compared to group LIRA,the levels of insulin,C-peptide,gastrin,and cholecystokinin in LIRA + BM-MSCs group were increased (P ＜ 0.05),there was no significantly difference in glucagon or GLP-1 (P＞0.05).The analysis revealed that the level of insulin was positively correlated with gastrin (r =0.544,P＜0.01),cholecystokinin (r =0.710,P＜0.01) and GLP-1 (r =0.669,P＜ 0.01),but was negatively correlated with glucagon (r =-0.506,P＜0.01);the level of glucagon was negatively correlated with gastrin (r =-0.364,P＜0.05),cholecystokinin (r =-0.433,P＜0.01) and GLP-1 (r =-0.591,P＜ 0.01).Compared to the other three groups respectively,immunohistochemistry displayed that the positive area of insulin in pancreas was significantly increased in LIRA + BM-MSCs group,while that of glucagon was decreased (P＜ 0.05).Conclusions By means of regulating gastrointestinal hormones efficiently,combination of liraglutide withBM-MSCs may improve glucose metabolism more efficaciously than treatment with a single agent in T1DM rats.

Simultaneous concurrence of subacute thyroiditis and Graves' disease is rare.We present one case of subacute thyroiditis with Graves' disease and combine with other reports to explore the clinical characteristics and therapeutic considerations.If subacute thyroiditis is considered coexisting simultaneously with Graves' disease,radioactive iodine uptake,thyroid autoantibody,fine-needle aspiration of thyroid gland,thyroid nuclide imaging examination,etc,should be done to make correct diagnosis and to adjust the therapeutic plan.

Objective To evaluate the efficacy and safety of human glucagon-like peptide-1 analogue liraglutide in newly diagnosed type 2 diabetes mellitus (T2DM) with glycosylated hemoglobin A1c (HbA1c) ＞ 9％.Methods This was an open-labelled,randomized,parallel-group,treat-to-target trial.Newly diagnosed T2DM patients with HbA1c ＞ 9％ were enrolled.These patients were treated with metformin with repaglinide and randomized to receive once-daily liraglutide (LIRA,n =25) or the insulin glargine (IGla,n =24) at bedtime.Efficacy and safety were assessed and compared after 18-month treatment.Results (1) Compared with the baseline,patients with LIRA had significantly reduced mean body weight,BMI and waist circumference (P ＜ 0.01),whereas,the above indexes were increased (P ＜ 0.01) in patients treated with IGla.(2) After 18 months of treatment,fasting plasma glucose (FPG),2-hour plasma glucose after a 75g oral glucose load(2hPG) and HbA1c were significantly improved in all patients (P ＜ 0.01),with 2hPG,mean blood glucose (MBG),the largest amplitude of glycemic excursions (LAGE),mean amplitude of glycemic excursions (MAGE) were significantly lower in LIRA group than in IGla group (all P ＜ 0.05).(3) HOMA-IR decreased in both groups (P ＜ 0.05).However,△I30/△G30,AUCCP180 and Matsuda index were only significantly increased in patients treated with LIRA (respectively,4.88 ± 1.55 vs 7.60 ± 1.91,9.23 ± 2.66 vs 13.18 ± 2.72,39.28 ± 20.35 vs 54.64 ± 23.34,all P ＜ 0.01),while HOMA-IR reduced(4.41 ± 1.58 vs 3.52 ± 1.44,P ＜0.05).But in IGla group only HOMAIR was reduced (4.92 ± 1.84 vs 4.57 ± 1.80,P ＜0.05).The index of △I30/△G30,AUCCP180 and Matsuda index in LIRA group are higher than those of indexes in IGla group(respectively,7.60 ± 1.91 vs 4.18 ± 1.00,13.18 ± 2.72 vs 10.53 ± 2.68,54.64 ± 23.34 vs 41.65 ± 17.84,all P ＜ 0.05),while HOMA-IR is lower (3.52 ± 1.44 vs 4.57 ± 1.80,P ＜ 0.05).(4) The rate of HbA1 c ≤ 6.5 ％ and the dosages of oral anti-diabetic drugs in LIRA group were significantly better than that in IGla group.(5) No significant differences were observed in hypoglycemic episodes and adverse events between two groups.Conclusion It seems that liraglutide is superior to insulin glargine in newly diagnosed T2DM patients with HbA1c ＞ 9％ in improving beta-cell function,insulin sensitivity and glucose homeostasis.

Objective To investigate the clinical effect of azithromycin on ankylosing spondylitis (AS). Methods Sixty-four AS patients with active disease were enrolled in this study. Among them, thirty-two AS patients (treatment group)received Azithromycin treatment at a dose of 0.5 g once a day for a period of 5~7 days , and another thirty-two patients receiving conventional treatment served as control (control group). BASDAI, CRP and ESR served as the disease activity evaluation index. Results Activity indexes in two groups of in the first 4~ 20 weeks of the treatment were decreased compared with those before the treatment (P < 0.05), while a rise was found in the 20 ~ 24 week and activity indexes gradually returned to pretreatment levels. At 0 ~ 16 weeks , the disease activity index of treatment group was below normal levels but that of control group was higher than the normal level with significant difference (P < 0.05). Conclusion The treatment of Azithromycin can control the disease activity of AS in the long term, which would be a new proposal in AS treatment.

Objective To observe the effect and safety of the human glucagon-like peptide-1 analogue,liraglutide,versus insulin glargine in patients with type 2 diabetes mellitus inadequately controlled with metformin alone.Method Ninty patients with type 2 diabetes mellitus(aged 18-79 years,HbA1C 7.5％-10.0％,body mass index＜40 kg/m2) who had inadequate glycaemic control on metformin were allocated for the research with an open,randomized,parallel controlled clinical research method.The patients kept the original dose of metformin unchanged and were randomly assigned to the liraglutide group or the insulin glargine group according to a proportion of 1 ∶ 1.Liraglutide group started with a dose of 0.6 mg subcutaneous injection qd,changed to 1.2 mg subcutaneous injection qd after one week and kept unchanged until the end of the research.Insulin glargine group started with a dose of 0.1-0.2 U/kg according to the fingertips peripheral blood glucose level before breakfast on the continuous 3 d before every follow-up.At the baseline,after 4 weeks,12 weeks,20 weeks,and 26 weeks of treatment,HbA1C,blood glucose,lipids weight,blood pressure were arranged to measured.86 patients finally completed the study.Results Mean HbA1C and the success rate of HbA1C ＜7％ were similar between liraglutide group and insulin glargine group [(7.06 ± 0.87) ％ vs (7.25 ± 1.20) ％,47.73 ％ vs 45.23 ％,P＞0.05],while the percentage of subjects reaching the composite endpoint of HbA1C＜7％ with no hypoglycemia and no weight gain was significantly higher in liraglutide group than insulin group(P＜0.05) ; Fasting plasma glucose decreased more markedly in insulin glargine group,2 h postprandial plasma glucose was decreased more markedly in liraglutide group(P＜0.05 or P＜0.01).Liraglutide significantly reduced mean body weight by (3.21 ± 1.18) kg,waist circumference by (3.82 ± 1.21) cm,and body mass index by (1.95 ± 0.61) kg/m2 (P＜0.01 or P＜0.05),while in the insulin glargine group there sere rise of respective figure of(2.86 ± 0.43) kg,(1.52 ± 0.56) cm,and (0.61 ± 0.25) kg/m2 (P＜0.05),systolic blood pressure and serum triglyceride declined.There was no serious adverse affect in both groups,the incidence of mild hypoglycemia was significantly less in liraglutide group and has a statistically significant difference (4.55％ vs 21.43％,P＜0.05).Conclusions Liraglutide showed a good effect on reducing weight,systolic blood pressure,blood lipid and in addition to blood glucose control which is comparable to insulin glargine.What is more,liraglutide had good safety and tolerability,which can be regarded as a good choice for patients with type 2 diabetes mellitus inadequately controlled with metformin alone.

Objective To evaluate the effects and safety of tarcrolimus on children difficult nephritic syndrome.Methods Databases including the Cochrane Library,Pubmed,Medline,OVID,CNKI,Wan Fang Data and VIP were searched to collect the controlled trials on tacrolimus capsule published from Jan 2003 to Jun 2013.The quality of the included randomized controlled trials was assessed by Jadad,and the complete remission,the fail,the relapsing rate of 12 month and side effects after treatment were extracted,meta-analysis was performed using RevMan 5.0 software.Results Among 179 articles,6 articles were included,4 of them were English and the other 2 were Chinese.The results of meta-analysis based on stratified therapeutic strategies showed that:(1) comparing with cyclophosphamide,tacrolimus could decrease the fail and relapsing rate of 12 month,but could not increase the complete remission (P ＞ 0.05).(2) Comparing with cyclosporine A,tacrolimus had no difference in complete remission and the relapsing rate of 12 month (P ＞ 0.05),but could decrease the fail.(3) Tacrolimus could increase the complete remission and decrease fail,but had no difference in relapsing rate (P ＞ 0.05).(4) There was no significant difference in relapsing rate between tacrolimus and rituximab(P ＞ 0.05).(5) Tacrolimus had less side effects than cyclophosphamide.Conclusion Tacrolimus have advantages to cyclophosphamide,cyclosporine A and prednisolone,but not to rituximab,and have less side effects than cyclophosphamide.