Exploration on the Clinical Application of Ephedrae Herba in Stimulating Yang Qi / 广州中医药大学学报

Based on the literature review and the analysis of specific cases of postpartum frequent micturition,pediatric enuresis,elderly uremia complicated with bradyarrhythmia in clinic,the clinical application of the action of Ephedrae Herba in stimulating yang qi is discussed.Ephedrae Herba has the meridian tropism of the lung and bladder meridians,and is pungent,warm and dispersing,which is the most important medicine for the treatment of external contraction.Ephedrae Herba has the actions of inducing diaphoresis,calming asthma and inducing diuresis,and is widely used for the treatment of external contraction,coughing and asthma,and edema.For the patients with deficiency of both kidney yin and kidney yang without obvious bias of yin-yang consumption which result from the postpartum impairment of qi and blood,deficient innate endowment,and gradually exhaustion of essence in the kidney in the elderly or during chronic illness,a small dosage of Ephedrae Herba can stimulate yang qi during the treatment of warming kidney yang,which is helpful for promoting the drug arriving at the back shu-points of the internal organs distributed along the bladder meridian and enhancing the recovery of zang-fu organ function.Ephedrae Herba is strong in inducing diaphoresis with an intense action.When Ephedrae Herba is used to stimulate yang,the dosage of 3～9 g is appropriate,and medicines for warming yang are needs to be used together.The course of treatment with Ephedrae Herba should be avoided to be too long,in order to prevent the vital energy from the damage by its large cumulative dose.

Effect of microevolution on phenotypes and drug resistance of the Trichosporon asahii biofilm / 中华皮肤科杂志

Objective:To evaluate the effect of microevolution on phenotypes and drug resistance of the Trichosporon asahii biofilm. Methods:The standard strain of Trichosporon asahii was obtained from the Fungal Biodiversity Institute of the Royal Netherlands Academy of Arts and Sciences, the fluconazole-sensitive primary strain (TO) of Trichosporon asahii was isolated from a case of trichosporonosis diagnosed in the Department of Dermatology, the Seventh Medical Center of Chinese People′s Liberation Army General Hospital in 2000, and the fluconazole-resistant evolved strain (TEVO) of Trichosporon asahii was isolated from the above patient in 2014. Biofilms of the above-mentioned strains were formed in vitro, and tetrazolium salt XTT reduction assay was performed to evaluate growth kinetics of the Trichosporon asahii biofilm, and laser scanning confocal microscopy to determine the thickness of the biofilm; the sessile minimum inhibitory concentrations (SMICs) of fluconazole, itraconazole and voriconazole against the biofilms at different growth stages were determined in vitro for the evaluation of the resistance of the biofilms. One-way analysis of variance was used for comparisons among multiple groups, and Hartley test for testing homogeneity of variance. If the variance was homogeneous, least significant difference test was used for multiple comparisons; if the variance was heterogeneous, Tamhane′ T2 test was used for multiple comparisons. Results:In the adhesion (0 h) and formation stages (4- 24 hours) of the Trichosporon asahii biofilm, the metabolic activity of the evolved strain TEVO was the weakest (adhesion stage: F = 35.705, P < 0.001; formation stage: F = 15.042, P < 0.001) . At 48 hours after adhesion, the biofilms matured, and the TO strain showed the weakest metabolic activity ( F = 10.985, P < 0.001) . In the maturation stage, the biofilm thickness of the TEVO strain (26.1 ± 1.18 μm) was significantly higher than that of the TO strain (22.8 ± 1.73 μm, P = 0.001) , but significantly lower than that of the standard strain (29.5 ± 1.28 μm, P = 0.001) . As drug susceptibility testing showed, the SMICs of azole antifungal agents against the TEVO strain were higher than those against the TO strain in the adhesion and formation stages of the Trichosporon asahii biofilm, and the SMICs of azole antifungal agents against the biofilms of the 3 strains of Trichosporon asahii were all over 1 024 mg/L in the maturation stage of the biofilm. Conclusion:Under the dual pressure of host environment and antifungal drugs, adaptive changes took place in the phenotypes of the Trichosporon asahii biofilm with an increase in the resistance to azole antifungal drugs.

Safety of enzalutamide in patients with mCRPC with hepatic dysfunction / 中华泌尿外科杂志

In March 2019, a patient with advanced prostate cancer was diagnosed in Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, and the disease progressed to the stage of mCRPC after traditional endocrinotherapy. Serious adverse event occurred after 1 month of treatment with abiraterone, which result in drug withdrawal, and replaced therapy by enzalutamide, the effect was good.

Propionibacterium acnes: renaming and its correlation with acne vulgaris / 中华皮肤科杂志

Recently, biochemical and genomic studies have specified new classification methods and renamed Propionibacterium acnes as Cutibacterium acnes ( C. acnes) to better study its phylotypes and distinguish it from other Propionibacterium species . C. acnes, an important commensal bacterium in human skin, is involved in maintaining skin health, and can also turn into an opportunistic pathogen causing acne vulgaris. Latest studies have showed that the balance between different phylotypes of C. acnes and its interaction with other microorganisms play a key role in the occurrence and development of acne vulgaris. This review summarizes correlations between C. acnes phylotypes and acne vulgaris, as well as antimicrobial susceptibility and interaction with other microorganism of C. acnes.

Application of Multiple Genetic Markers in Determination of Full and Half Sibling Relationship： A Case Report / 法医学杂志

Objective To investigate the application of the comprehensive use of multiple genetic markers in full and half sibling relationship testing through the identification of a case of suspected sibling relationship. Methods Genomic DNA were extracted from bloodstain samples from 4 subjects （ZHANG-1, ZHANG-2, male; ZHANG-3, ZHANG-4, female）. Autosomal STR loci, X-STR, Y-STR loci and polymorphisms of mtDNA HV-Ⅰ and Ⅱwere genotyped by EX20 STR kit, X19 kit, Data Y24 STR kit, and Sanger sequencing, respectively. Results According to autosomal STR based IBS scoring results, full sibling relationships were indicated among ZHANG-2, ZHANG-3 and ZHANG-4, but those were not indicated between ZHANG-1 and ZHANG-2 or ZHANG-3 or ZHANG-4. According to autosomal STR based FSI and HSI, with ITO method and discriminant function method, full sibling relationships among ZHANG-2, ZHANG-3 and ZHANG-4 were indicated, and half sibling relationships between ZHANG-1 and ZHANG-2 or ZHANG-3 or ZHANG-4 were also indicated. X-STR and mtDNA sequencing results showed that all the 4 samples came from a same maternal line, and Y-STR results showed that ZHANG-1 and ZHANG-2 did not come from a same paternal line, which supported the half sibling relationship between ZHANG-1 and ZHANG-2 or ZHANG-3 or ZHANG-4, verified by parental genotype reconstruction based on autosomal STR genotyping. Conclusion For the identification of sibling relationships, it is effective to have reliable results with the mutual verification and support of multiple genetic markers （autosomal STR, sex chromosomal STR and mtDNA sequence） and calculations （IBS, ITO, discriminant function method and family reconstruction）.

Comparison of prognosis on patients with coronary critical lesion assessed by coronary angiography , FFR and FD-OCT / 心血管康复医学杂志

Objective :To explore influence on prognosis in patients with coronary critical lesion assessed by coronary angiography (CAG) ,CAG combined coronary fractional flow reserve test (FFR) and CAG combined frequency do-main optical coherence tomography (FD-OCT ).Methods : Patients with coronary critical lesion who don't need stenting were screened by three detection programs , they were divided into CAG group (n＝ 45 , only received CAG) ,CAG+ FFR group (n＝45 ,received CAG+FFR) and CAG+ FD-OCT group (n＝45 ,received CAG+ FD-OCT).All three groups received secondary prevention of stable coronary heart disease for half a year .Incidence rates of angina pectoris (aggravated ) ,myocardial infarction and target vessel revascularization rate were observed and compared among three groups .Results :Compared with CAG group ,there were significant reductions in inci-dence rates of angina pectoris (33.3% vs.4.4%,6.7%) ,myocardial infarction (20.0% vs.4.4%,2.2%) and target vessel revascularization rate (26.6% vs.6.7%,2.2%) in CAG+FFR group and CAG+FD-OCT group ,P＜0.05 or ＜0.01. There were no significant difference between CAG + FFR group and CAG+ FD-OCT group , P＞0.05 all.Conclusion : Compared with pure CAG ,CAG combined FFR or FD-OCT can more effectively assess cardi-ac blood supply ,and improvement prognosis in patients with critical lesion .

Comparative study of efficacy and safety of compound pioglitazone hydrochloride glimepiride tablet and glimepiride tablet in treating type 2 diabetes mellitus / 重庆医学

Objective To compare the efficacy and safety of compound pioglitazone hydrochloririe glimepiride tablet and glimepiride tablet in the treatment of type 2 diabetic mellitus(T2DM) for evaluating the effectiveness and safety of compound pioglitazone hydrochloride glimepiride tablet for treating T2DM.Methods The random,double-blind,double-dummy,positive drugs parallel control clinical study method was adopted.Thirty-three T2DM patients with poorly controlled blood glucose were randomly assigned to the test group(n=22) and control group(n=11) by the 2 ∶ 1 ratio.The test group was given compound pioglitazone hydrochloride glimepiride tablet,while the control group received glimepiride tablet.The treatment cycle was 12 weeks.The differences of FBG,HbA1c,FINS and HOMA-IR in the two groups were compared between before and after treatment.Moreover the changes of body mass,blood pressure and blood lipids as well as adverse events occurrence were compared between the two groups.Results Thirty-one cases finished the treatment follow up(21 cases in the test group and 10 cases in the control group);the decreased amplitudes of HbA1c levels after 12-week treatment in the test group and control group were (0.99 ± 1.87)％ and (-0.02 ± 0.90) ％ respectively,which of FPG were (0.94 ± 1.87) mmol/L and (0.37 ± 2.62) mmol/L respectively.The FPG and HbA1c levels after treatment in the test group were decreased compared with before treatment,the difference was statistically significant (P＜0.01).The change difference of FPG and HbA1c in the control group had no statistical difference(P＞0.05).FINS and HOMO-IR in the test group were significantly decreased before and after treatment,the difference was statistically significant (P＜0.01).The incidence rate of hypoglycemia had no statistically significant difference between the test group and control group.Conclusion The effectiveness of compound pioglitazone hydrochloride glimepiride tablet in treating T2 DM is superior to the single use of glimepiride,while the safety is equivalent to single use of glimepiride.

Identification of a novel GPR143 mutation in a Chinese family affected with X-linked ocular albinism / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To detect mutation of GPR143 gene in a Chinese patient affected with ocular albinism.</p><p><b>METHODS</b>Peripheral blood samples were collected from the proband and his parents. The coding regions of the GPR143 gene were subjected to PCR amplification and Sanger sequencing.</p><p><b>RESULTS</b>A previously unreported mutation (c.758T>A) was found in exon 6 of the GPR143 gene in the proband and his mother. The same mutation was not found in his father. As predicted, the mutation has resulted in a stop codon, causing premature termination of protein translation.</p><p><b>CONCLUSION</b>A novel mutation of the GPR143 gene related to X-linked ocular albinism has been identified.</p>

Differences in expression of Ras1, Rac1 and Rho1 genes between yeast and hyphal phases of Trichosporon asahii / 中华皮肤科杂志

Objective To investigate differences in the expression of Ras 1,Rac1 and Rho1 genes between yeast and hyphal phases of Trichosporon asahii (T.asahii),and to explore their roles in the formation of hyphae.Methods The yeast phase and hyphal phase of T.asahii were cultured and served as yeast phase group and hyphal phase group respectively.Total RNA was extracted from the 2 groups,and real -time fluorescence-based quantitative PCR (RT-PCR) was performed to measure the mRNA expression of Ras1,Rac1 and Rho1.Results The hyphal formation rate was significantly lower in the yeast phase group than in the hyphal phase group (0.40％ ± 0.53％ vs.99.33％ ± 0.57％,t =13.93,P ＜ 0.05).When the mRNA expression of Ras1,Rac1 and Rho1 in the yeast phase group was all set as 1,that in the hyphal phase group was 25.17 ± 10.99,16.81 ± 7.80,42.61 ± 18.50,respectively,with significant differences between the two groups in the three parameters (t =3.81,3.51,3.90,respectively,all P ＜ 0.05).Conclusion Ras1,Rac1 and Rho1 genes may participate in the regulation of hyphal formation in T.asahii.

Nursing experience of 6 patients with severe pneumonia caused by H7N9 avian influenza / 中国实用护理杂志

Objective To summarize the nursing points of 6 patients with severe pneumonia caused by H7N9 avian influenza. Methods Six patients with pneumonia caused by H7N9 avian influenza in central Sichuan region were admitted from January to April 2017. Under the guidance of avian influenza expert group of Sichuan province, careful respiratory nursing for avian influenza patients were carried out, including mechanical ventilation, sputum suction, chest physiotherapy, the prevention of ventilator associated pneumonia and respiratory function exercise. Results Four patients of 6 patients were discharged from the hospital with the efforts of all medical staff, and 2 patients died unfortunately. Conclusions The severe pneumonia caused by avian influenza has a high death rate. Because respiratory nursing is one of most important treatments for avian influenza patients, this article summarized nursing points in this article as a reference for medical staff.

Nursing experience of 6 patients with severe pneumonia caused by H7N9 avian influenza / 中国实用护理杂志

Objective To summarize the nursing points of 6 patients with severe pneumonia caused by H7N9 avian influenza. Methods Six patients with pneumonia caused by H7N9 avian influenza in central Sichuan region were admitted from January to April 2017. Under the guidance of avian influenza expert group of Sichuan province, careful respiratory nursing for avian influenza patients were carried out, including mechanical ventilation, sputum suction, chest physiotherapy, the prevention of ventilator associated pneumonia and respiratory function exercise. Results Four patients of 6 patients were discharged from the hospital with the efforts of all medical staff, and 2 patients died unfortunately. Conclusions The severe pneumonia caused by avian influenza has a high death rate. Because respiratory nursing is one of most important treatments for avian influenza patients, this article summarized nursing points in this article as a reference for medical staff.

Improvement Effect of Modified Mahuang Chanyi Decoction on Allergic Rhinitis Model Guinea Pigs and Its Mechanism Study / 中国药房

OBJECTIVE:To study improvement effect of modified mahuang chanyi decoction on allergic rhinitis(AR)model guinea pigs and its mechanism. METHODS:32 guinea pigs were randomly divided into normal group (0.9% Sodium chloride in-jection),model group (0.9% Sodium chloride injection),experimental [Modified mahuang chanyi decoction,5.18 g (medicinal materials)/kg] group and control [Fluticasone propionate nasal spray,50 μg/(guinea pig·d)] group. Except for normal group,other groups received ovalbumin 30 mg and calmogastrin 30 mg intraperitoneally to induce AR model. Except for control group,other groups were given relevant medicine intragastrically,twice a day for consecutive 15 d. Nasal symptoms of guinea pigs were ob-served and recorded,and then analyzed and scored. The protein expression of nasal mucosa SHP-1 was detected by immunohisto-chemistry,the serum contents of IL-4 and IFN-γ were determined by enzyme-linked immunosorbent assay. RESULTS:Compared with normal group,model group suffered from AR symptom,and nasal symptoms score was increased;and the protein expression of nasal mucosa SHP-1 and the serum content of IL-4 increased,while the content of IFN-γ decreased(P<0.05). Compared with model group,AR symptom of experimental group and control group were improved;nasal symptoms score,the protein expression of nasal mucosa SHP-1 and the serum content of IL-4 decreased while the content of IFN-γ increased(P<0.05). CONCLUSIONS:Modified mahuang chanyi decoction shows certain improvement effect on AR,and its mechanism is associated the decrease of IL-4 content and the increase of IFN-γcontent in serum.

A PubMed-based bibliometric analysis on research of pruritus / 第二军医大学学报

Objective To analyze the distribution and characteristics of pruritus/itch literatures and understand the current research status, so as to provide evidence for future research on pruritus/itch. Methods Literatures on pruritus/itch since 1970 in PubMed database were analyzed by bibliometric tool-Thomson Data Analyzer. The distributions of year, nation, journal, author and current focus area on pruritus/itch were analyzed, and the author cooperation network diagram was plotted. Results The earliest literature of pruritus/itch was traced back to 1843, and the number of papers published during 1970 to 1980 was stable, but after that the number witnessed a steady increase annually. The United States and Germany played a leading role in the the papers of pruritus/itch. The numbers of papers from Japan, the United Kingdom, Italy and France were also great. The top three journals that published the most papers of pruritus/itch were: Journal of the American Academy of Dermatology, British Journal of Dermatology and Archives of Dermatology. Professor Yosipovitch G from Wake Forest Medical Center(USA), professor Staender S from the Intensive Care Medicine and Anesthesiology Department, Maennedorf Regional Hospital (Germany) and professor Ring J from Allergy and Dermatology Department, University of Munich (Germany) were the top 3 authors who published the most papers on pruritus/itch. The research focuses in the field of pruritus/itch included diagnosis, differential diagnosis and treatment. Conclusion The United States and European countries are the main players in research of pruritus/itch. More Chinese research teams should join in the research on pruritus/itch. Clinical diagnosis and treatment of pruritus/itch are supposed to be the main future focus of pruritus/itch field.

Significance of serum IL-17,IL-23 in patients with allergic rhinitis / 中国免疫学杂志

Objective:To explore the expression level of IL-17,IL-23 in patients with allergic rhinitis (AR) and their clinical significance.Methods:A total of 25 patients with AR were treated as observe group , and 23 healthy volunteers were chosen as the control group.The levels of serum IL-17,IL-23 and specific-IgE ( s-IgE) were compared between the two groups.The relationships among serum IL-17,IL-23 and sIgE in patients with AR were discussed.Results:The levels of IL-17,IL-23 and sIgE in observe group were significantly higher than in control group.There was a positive linear correlation between the IL-17 and IL-23/the IL-23 and sIgE/the sIgE and IL-17 in observe group.Conclusion: The IL-17 , IL-23 might be the two important cytokine in the occurrence and development process of allergic rhinitis.The IL-17,IL-23 might be related to the formation of sIgE.

Clinical comprehensive treatment of refractory chronic rhinosinusitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the methods and efficacy of comprehensive treatment on retractory chronic rhinosinusitis(CRS).@*METHOD@#Thirty-two cases of patients with refractory rhinosinusitis took part in individualized comprehensive treatment program, that is, a healthy diet and moderate exercise, psychological counseling, and reasonable operation and gauze changing, and rational use of drug therapy.@*RESULT@#All patients were followed up for 6 months or more, 26 cases (81.3%) were completely controlled of the disease, 6 cases (18.7%) were partially controlled; the total effective rate was 100%.@*CONCLUSION@#In the current situation that CRS etiology and pathogenesis studies have not yet made a breakthrough, and we have not developed a new and effective drug, comprehensive treatment focusing on internal and external factors of refractory rhinosinusitis at the same time, that is, to take a rational healthy diet, moderate exercise, psychological counseling, and reasonable operation and gauze changing, and rational use of drug therapy ect. can obtain better effect.

Comparative Analysis of Four Different Operation Methods for Treatment of Complex Upper Ureteral Calculi / 昆明医科大学学报

Objective To compare the effects of ureteroscopic lithotripsy (URL), minimally invasive percutaneous nephrolithotomy ( MPCNL) , retroperitoneal laparoscopic ureterolithotomy ( RLU) and open ureterolithotomy (UL) for the treatment of complex upper ureteral calculi. Methods The data of 281 patients with complex upper ureteral calculi from January 2005 to January 2013 were retrospectively reviewed. 48 patients of them received treatment of URL, 113 patients received MPCNL, 67 patients received RLU and other 53 patients received UL. Results Success rates of treatment at the first time were:URL 62.5% (30/48), MPCNL 92.9%(105/113),RLU 100%(67/67) and UL 100%(53/53) . The mean blood losses during the operation were:URL (9.2 ± 1.4) mL,MPCNL (72.5 ± 5.8) mL,RLU (43.1 ± 8.5) mL and UL (100.5 ± 9.2) mL. The average operation time of URL group was shorter than three other groups, and the difference was statistically significant (P0.05) . Conclusion Clinical characteristics of patients and individual require ment should be considered comprehensively before an individual treatment choice is made for the treatment of complex upper ureteral calculi.

Epidemiology of opportunistic invasive fungal infections in China: review of literature / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To summarize the recent findings on the epidemiology of medically important, opportunistic invasive fungal infections (IFIs) in China and discuss the relevant social, economical reasons and medical factors.</p><p><b>DATA SOURCES</b>We performed a comprehensive search of both English and Chinese literatures of opportunistic IFIs from China up to April 2012.</p><p><b>STUDY SELECTION</b>Relevant literatures involving researches and cases/case series were identified, retrieved and reviewed.</p><p><b>RESULTS</b>The incidence of opportunistic IFIs in China was steadily increasing. The incidence and mortality of IFIs were different in patients with various underlying conditions/diseases, from 4.12% to 41.18% and 9.8% to 60.0%, respectively. Candida species, Aspergillus species and Cryptococcus neoformans species complex were the most frequent isolated pathogens. Other uncommon opportunistic IFIs were also been reported, including trichosporonosis, mucormycosis, hyalohyphomycosis (hyaline hyphomycetes) and phaeohyphomycosis (dematiaceous hyphomycetes). Reports of Chinese patients differed from those of many other countries as there were a higher number of patients without identifiable underlying diseases/conditions.</p><p><b>CONCLUSIONS</b>Because of the rapid economic development, changing population structure and a growing number of immunocompromised hosts with risk factors, today opportunistic IFIs in China have a significant impact on public health, associated with high morbidity/mortality and higher care costs. Now information related to the epidemiology of opportunistic IFIs in China is still sparse, so we need more organized groups of clinical scientists performing related researches to help the clinicians to obtain more accurate epidemiological characteristics.</p>

In vitro induction and stability evaluation of fluconazole resistance in Trichosporon asahii / 中华皮肤科杂志

Objective To induce fluconazole resistance in T.asahii by culture in medium containing increasing concentrations of fluconazole,and to evaluate the stability of the induced resistance.Methods Two T.asahii strains with a highest sensitivity to fluoconazole,including a clinical isolate CBS2479 (minumum inhibitory concentration (MIC) =0.25 μg/ml) and an environmental isolate CBS8904 (MIC =1.5 μg/ml),were selected from 11 T.asahii strains stored in the laboratory of the Department of Dermatology,General Hospital of Beijing Military Region.Both strains were respectively and serially subcultured in potato dextrose agar (PDA) medium containing growing concentrations of fluconazole (from 0.5 MIC to 256 μg/ml).E-test was performed to evaluate the susceptibility of T.asahii to fluconazole after each passage.To evaluate the stability of fluconazole resistance,the T.asahii isolates with induced resistance (MIC ＞ 256 μg/ml) were serially subcultured in drug-free PDA medium,and drug susceptibility assay was performed after each subculture.Results After serial culture in PDA medium containing fluconazole,high level of fluconazole resistance (MIC ＞ 256 μg/ml) developed in both of the fluconazole-susceptible T.asahii strains CBS2479 and CBS8904.The MIC value of fluconazole remained unchanged in the fluconazole-resistant strain CBS2479R,but gradually decreased to 64 μg/ml in the other resistant strain CBS8904R after 18-day culture in fluconazole-free PDA medium.Conclusions Fluconazole resistance can be induced in T.asahii strains from different origins by serial culture in medium containing growing concentrations of fluconazole,and the stability of the induced fluconazole resistance varies between strains of different origins.

Calcification of bilateral ureters: a novel association with systemic lupus erythematosus / 中华医学杂志(英文版)

A 16-year-old female patient with systemic lupus erythematosus (SLE) presented with abdominal pain and oliguria, after one month of hospital treatment with methylprednisolone and cyclophosphamide. Computed tomography of the abdomen revealed the calcification of bilateral superior segmental ureteral wall. Computed tomography urography revealed stenosis of bilateral ureters. This calcification may be associated with lupus-induced inflammatory reaction of ureteral endomembrane. By receiving the ureteral catheters, her abdominal pain and oliguria had been completely resolved. After discharge, she underwent the surgery of cutaneous ureterostomy in the local hospital. During two years follow-up, her condition is stable without any symptom of the urinary system.

Effect of mitiglinide calcium on fasting plasma fibroblast growth factor-21 level in patients with newly diagnosed type 2 diabetes mellitus / 中华内分泌代谢杂志

Eighty-two newly-diagnosed type 2 diabetic patients with poor glycemic control were treated by mitiglinide calcium for 16 weeks.Plasma fibroblast growth factor-21 ( FGF-21 ) level were evaluated.The relationship of plasma FGF-21 levels with body mass index,body fat,waist-to-hip ratio,lipid,blood glucose,HbA1c,and free fatty-acid were analyzed.Plasma FGF-21 was decreased significantly by treatment with mitiglinide calcium in type 2 diabetic patients,and it may play a role in the pathogenesis of type 2 diabetes mellitus.