ABSTRACT
Metformin is currently the first-line drug for the treatment of type 2 diabetes, and it is the most widely used oral hypoglycemic drug in the world. In addition to its significant hypoglycemic effect, metformin also has potential therapeutic effects on diseases such as tumors, obesity, thyroid diseases, polycystic ovarian diseases and cardiovascular diseases. However, the specific mechanism of action of metformin is still unclear. A large number of studies have shown that the regulation of energy metabolism by metformin is not only the core of its mechanism of action in the treatment of type 2 diabetes, but also an important mechanism for its therapeutic effects in diseases such as tumors and cardiovascular diseases. In this paper, the clinical application and related drug mechanisms of metformin in the treatment of non-diabetic diseases were summarized, so as to provide reference for the majority of medical workers, and look forward to a more in-depth exploration of its drug mechanism and clinical application in the future.
ABSTRACT
Objective To investigate if the endothelin-1 (ET-1),nitric oxide(NO) can affect renal artery blood flow and explore the clinical value of ultrasonography in hypertensive disorder complication pregnancy.Methods 18 patients of gestational hypertension,18 patients of gently preeclampsia,20 patients of severe preeclampsia and 20 normal pregnancy women were chosen in random.Color Doppler ultrasonography was used to detect the peak systolic velocity (PSV),end diastolic velocity (EDV),resistive index (RI),pulsatility index (PI) of renal interlobar artery.The levels of serum ET-1 and NO were measured by enzyme-linked immunosorbent assay (ELISA) and nitric acid recovery respectively.Results The level of EDV in preeclampsia patients were significant lower than the control group (P ＜0.05).The levels of RI,PI,S/D in preeclampsia patients were significant higher than the control group (P ＜0.05).The level of ET-1 in study group was higher than control group (P ＜0.01).The level of NO in study group was lower than control group (P ＜0.01).There was positive correlation between the RI,PI,S/D of renal interlobar artery and the level of serum ET-1.There was inverse correlation between the RI,PI,S/D of renal interlobar artery and the level of serum NO.Conclusions Endothelial dysfunction can cause unbalance of renal vessel systolic-diastolic function.The level of renal artery blood flow parameters can reflect the state of vessel function and have clinical value in hypertensive disorder complication pregnancy.
ABSTRACT
Objective To evaluate the clinical features,pathological grades,treatment and prognosis in bladder cancer patients under 40 years.Methods A retrospective review of transitional cell carcinoma of the bladder in patients under 40 years who had been treated from January 1994 to April 2005 were conduc- ted.The patients were divided into 2 groups(group A,20-30 years;group B,31-40 years)based on their age.The differences in pathologic grading,recurrence rate and positive rate of urine cytology were compared between the 2 groups.The statistical analyses were performed using x~2 test.Results The incidence of bladder cancer in patients under 40 years was 4.2%(92/2200).The male/female ratio was 2.7:1.0.At initial visit,86%(68.7% in group A and 91.1% in group B)of the patients presented with gross hematuri- a;and 25.0% in group A and 33.9% in group B concomitantly had frequency and dysuria.The mean disease course in the 2 groups was 3.8 months for male and 6.9 months for female.Solitary tumor occurred in 19 ca- ses(100.0%)in group A and 63(86.3%)in group B;and multiple carcinomas,in 10 cases(13.7%)in group B.All were superficial bladder cancers in group A,while 6(8.2%)were invasive carcinomas in group B.According to WHO pathological grading of bladder cancer,in group A,10 cases(52.6%)had G_1,8 (42.1%)had G_2 and 1(5.3%)had G_3 tumors;in group B,8 cases(11.0%)had G_1,49(67.1%)had G_2 and 16(21.9%)had G_3 tumors(P＜0.01).The positive rate of urine cytology was 53.3% in all 92 ca- ses(25.0% in group A and 60.7% in group B,P＜0.05).The diagnostic rates by B-ultrasound and cysto- scopy were 98.6% and 100.0%,respectively.Of the 92 patients,11(12.0%)were treated by partial cys- tectomy,73(79.3%)by TUR-Bt and 8(8.7%)by cystectomy.The follow-up was 3-115 months(mean, 39 months).The overall recurrence rate was 12.0%,with 5.3%(1/19)in group A and 13.7%(10/73)in group B.Of 10 patients with multiple carcinomas,6(60.0%)developed recurrence;and of 82 with solitary tumors,5(6.1%)developed recurrence,with significant difference between them(P＜0.01).Two of the multiple carcinoma patients developed invasive carcinoma.Conclusions In bladder cancer patients under 40 years,the positive rate of urine cytology,pathological grading and recurrence rate increase with age.Multi- ple tumors,invasive carcinoma and long-term smoking are high risk factors for tumor recurrence.TURBt is the main surgical method for treating bladder cancer patients under 40 years.