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Introduction The 'glutides,' which stimulate the glucagon-like peptide 1 (GLP-1) receptor to stimulate insulin secretion, are used in the treatment of type 2 diabetes. Semaglutide is the first glutide to be developed in an oral form. The PIONEER series of clinical trials (Peptide Innovation for Early Diabetes Treatment) were undertaken to establish a clinical role for oral semaglutide.Areas covered This evaluation is of PIONEER 6 in a non-inferiority phase 3a trial. In PIONEER 6, the primary outcome was the time from randomization to first occurrence of a major adverse cardiovascular event and this was non-inferior with oral semaglutide, compared to placebo.Expert opinion In my opinion, there are several reasons why once-daily oral semaglutide may not replace once-weekly subcutaneous semaglutide in the treatment of type 2 diabetes. Most importantly, subcutaneous semaglutide has already been shown to be superior to placebo in reducing cardiovascular risk, whereas the study of this with oral semaglutide will not be completed until 2024. Secondly, it is debatable whether subjects will find the daily protocol for taking oral semaglutide more convenient than that for the weekly subcutaneous formulation.Introduction A range of combination chemotherapy regimens are currently used in clinical practice. However, international antiemetic guidelines often only categorize the emetogenic potential of single agents rather than the emetogenicity of combination chemotherapy regimens. To manage the nausea and vomiting induced by antineoplastic combinations, guidelines suggest antiemetics that are appropriate for the component drug with the highest emetogenic potential. Furthermore, antiemetic guidelines generally do not consider the influence of other factors, including individual patient characteristics, on the emetic effects of cancer treatments. Similarly, the emetogenic potential of radiotherapy is stratified only according to the site of radiation, while other factors contributing to emetic risk are overlooked.Areas covered An Expert Panel was convened to examine unresolved issues and summarize the current clinical research on managing nausea and vomiting associated with combination chemotherapy and radiotherapy.Expert opinion The panel identified the incidence of nausea and vomiting induced by multi-drug combination therapies currently used to treat cancer at different anatomic sites and by radiotherapy in the presence of other risk factors. Based on these data and the clinical experience of panel members, several suggestions are made for a practical approach to prevent or manage nausea and vomiting due to chemotherapy regimens and radiation therapy.This study aims to observe the clinical manifestations of fungal infection and summarize its multidisciplinary treatment. We described one case of multiple organ dysfunction caused by severe fungal infection and reviewed of the relevant literature. The early signs and symptoms were not specific in this patient, and the disease was characterized by quick changes, rapid progression, multiple organ involvement, and poor prognosis. Severe fungal infection is not a common or frequently occurring condition, with a low incidence of central nervous system (CNS) involvement. History-taking is helpful for diagnosis, and attention to disease progression and changes in the nervous system signs may facilitate the early diagnosis and treatment, reduce misdiagnosis and mistreatment, increase therapeutic effectiveness, and improve the quality of life.BACKGROUND Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor in the gastrointestinal tract. Small intestine is the second most popular location of GIST, named small intestinal stromal tumor (SIST). The cumulative incidence of malignancy of SIST is twice that of gastric GIST. However, research studies on SIST are relatively rare. METHODS The present retrospective study included 75 patients with SIST who underwent surgery resection and postoperative pathological diagnosis and analyzed the clinical manifestations, histopathological and immunohistochemical features, advantages and disadvantages of various auxiliary examinations, the treatment and prognosis of SIST. RESULTS The number of Patients who had gastrointestinal bleeding was significantly higher than patients who had abdominal mass. Cases in the jejunum was significantly more than that in duodenum and ileum groups. With the increase of tumor diameter, the invasion risk also gradually increased. Patients with adverse outcome had bigger tumor diameter than patients with favorable outcome. For patients with adverse outcome, the nuclear division >5/50 HPF constitution is significantly higher than patients with favorable outcome. When categorized into 3 cell types according to cell morphology, the spindle-epithelioid cell type appeared only in patients with adverse outcome. Cox regression analysis indicated that tumor diameter 5.3 cm or higher and nuclear division > 5/50 can be independent risk factors for predicting SIST postoperative adverse outcome. CONCLUSIONS The present study analyzed the clinical statistics of SIST patients and improved the understanding of this disease and provided valid statistics for clinical diagnosis and treatment.BACKGROUND Pancreatic beta cell damage induced by glucose toxicity is an important factor in type 2 diabetes mellitus (T2DM). It has become evident that endoplasmic reticulum stress (ERS)-induced apoptosis was contributed to beta cell dysfunction and insulin resistance. CBDCA Our previous work showed that emulsified isoflurane (EIso) could alleviate ERS in lung reperfusion injury. This study aimed to elucidate whether EIso could alleviate apoptosis induced by glucose in rat islet RIN-m5F beta cells via inhibiting ERS. METHODS RIN-m5F cells were divided into five groups the control group; the 0.1G group, cultured in 0.1M glucose for 24 h; the 0.3G group, cultured in 0.3M glucose for 24 h; the 0.3G + 57E group, cultured in 0.3M glucose with 57 µM EIso for 24 h, and the 0.3G + 76E group, cultured in 0.3M glucose with 76 µM EIso for 24 h. First, cell proliferation was measured by MTT assay, and the level of insulin secretion was measured with enzyme-linked immunosorbent assay (ELISA) kit. Second, the expression of B cell leukemia/lymphoma 2 (Bcl-2) associated X (Bax) and Bcl-2 were detected by Western blotting.

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