The modest pressure promotes the graduate to keep continuous energy and focus on scientific research,but too much pressure will lead to mental problem and serious moral shortcoming.Reformation of scientific evaluating and promoting system,enhancement of scientific interest and reconstruction of mental training system should be the important ways to release the pressure of scientific research of the graduate.

Severe acute pancreatitis (SAP) can induce intra-abdominal hypertension, which has an adverse effect on the function of urinary, circulatory, digestive and neurological system, and finally leads to abdominal compartment syndrome (ACS) if patients were not timely treated. This article focuses on the close relationship between SAP and ACS, which included the definition, classification, pathogenesis of ACS and its pathophysiologic effects on other important organs. The different types and indications of surgical interventions of ACS were discussed in detail. For SAP patients complicated with ACS, urgent open abdomen is important to decrease the abdominal pressure and to prevent the incidence of multi-organ dysfunction syndrome. Complications after open abdomen, such as intestine fistula,abdominal sepsis, intestinal dysfunction and abdominal deficit,should be managed prudently.

ObjectiveTo evaluate the efficacy and safety of ibutilide for conversion of paroxysmal and persistent atrial fibrillation.Methods31 patients with atrial fibrillation duration less than 90 days were included into amiodrone or ibutilide group.16 patients were intravenously administer with amiodrone and 15 patients with ibutilide separately.Conversion rate,time needed to converse and adverse effects were compared between two groups.ResultsThe total conversion rate of ibutilide group was significantly higher than that of amiodrone group (66.7％ vs 37.5％,x2 =1.98,P ＜ 0.05 ).Time needed to converse was significantly shortened in ibutilide group compared with amiodrone group [ ( 31.75 ± 7.39 ) min vs ( 51.87 ± 9.26 ) min,t =3.67,P ＜ 0.05 ].No clinical significant adverse effects were observed in ibutilide group.ConclusionIntravenous administration of ibutilide in cardioversion of paroxysmal and persistent atrial fibrillation was more safe and effective than amiodrone.

Allogeneic hematopoietie stem cell transplantation(alloHSCT) is a potentially curative therapy for patients with hematological malignant disease, autoimmune disease or hereditary disease.However, graftversus-host disease (GVHD), which is one of the most serious complications, influences the prognosis of alloHSCT. Mechanisms of GVHD is so complicated that there is still no perfect way to treat the patients at present. Recently, mesenchymal stem cells(MSC) become new hotspots because of their immunomodulatory properties and potential to suppress alloreactive T cell responses.Animal experiments showed that MSC were effective during the prevention and treatment of GVHD. This paper is to summarize the acting mechanism of MSC' effect on the prevention and treatment of GVHD after alloHSCT.

HbA1C has been used clinically since 1980s as the index of glycemic control in individuals with diabetes mellitus.Several significant clinical trials demonstrated that the intensive blood glucose control reduced the chronic complications in diabetes.In recent years,HbA1C has been recommended as one of the diagnostic criteria for diabetes mellitus.However,the standardization of HbA1C measurement still remains to be an important and arduous task in China.

This study tried to investigate the change in the glomerular filtration rate in initiation of a low-protein diet (LPD) in the elderly patients with diabetic nephropathy, and to elucidate whether this initial phenomenon is reversible or irreversible. 24 non-insulin-dependent diabetic patients with renal failure patients were randomized to LPDⅠgroup (0.6g *kg-1*24h-1), LPDⅡgroup (0.8g*kg-1*24h-1), and NPD group for four weeks (phaseⅠ). Between weeks 4 and 8, all patients received NPS (phaseⅡ). Dietary protein intake (g*kg-1*24h-1), SCr, Ccr, albuminuria excretion rate and arterial blood pressure were measured at baseline and after four- and eight-weeks of follow-up, respectively. During phaseⅠ, a significant decline in dietary protein intake, Ccr, Scr, and albuminuria excretion rate were observed in the LPDⅠgroup and LPDⅡgroup. There was not any change in the NPD group. Conversely, during phase Ⅱ, with a significant increase in dietary protein intake, Ccr, Scr and albuminuria excretion rate increased in LPDⅠ group and LPD Ⅱ group compared with the NPD group. It suggested that dietary protein restriction for four weeks induces a reversible decline in GFR, Scr and albuminuria excretion rate in noinsulin-dependent diabetic nephropathy patients with renal failure, whereas systemic blood pressure remains unchanged.

Liraglutide is a long-acting human GLP-1 analogue,which provides pharmacological level of GLP-1 and combines with GLP-1 receptor widely distributing in the body.Liraglutide demonstrates multiple antidiabetic and other effects,including glucose-dependent glucose-lowering action,pancreatic islet cells protection,gastric emptying inhibition,appetite reduction/feelings of satiety and fullness increasing,weight loss,cardioprotection and blood pressure lowering action.Meanwhile,clinical practice also shows that some gastrointestinal adverse events occur accompanying with good glucose control and weight loss.This review will explain the potential mechanisms of GLP-1 and gastrointestinal reaction,clinical evidence of liraglutide and effective management rules,aim to help readers better understand this issue,as well as to advise clinicians of proper use of liraglutide while reducing or avoiding those adverse events.

Eighty-five elderly patients treated for the upper gastrointestinal bleeding(UGB)in our hospital between January 2000 and December 2002 were divided into death or survival group.Their clinical characteristics,risk factors,treatment and complications were retrospectively analyzed.Eighteen patients died of UGB within 30 days.Univariate analysis indicated that documented diabetes,cardiovascular disease,cerebrovascular disease,gastric ulcer,hemoglobin,arrhythmia,stomach cancer,multiple organ dysfunction syndrome(MODS),and shock were significantly associated with inhospital mortality within 30 days(P＜0.05 or P＜0.01).Stomach cancer,MODS,and shock entered into the Logistic regression model.These findings demonstrate that stomach cancer,MODS,and shock might be independent risk factors for short-term prognosis in elderly UGB patients.

Hypoxia- inducible factor-1 ( HIF-1) promotes tumor deterioration, invasion and metasta-sis. Treatment targeting the HIF-1 signal pathway is becoming a hot research. In addition to uniquely selective inhibition of topoisomerase Ⅰ(Topo Ⅰ) ,the recent studies show that camptothecin compounds can regulate the activity of HIF-1 through decreasing HIF-1 protein translation and have been classified as a non-selective chemical inhibitor of HIF-1.

The Risk Evaluation of cAncers in Chinese diabeTic Individuals:A lONgitudinal(REACTION) Study is the largest prospective study of diabetes in China to date.It aims to investigate associations between type 2 diabetes and risks of cancer as well as cardiovascular diseases.The Study also examined the association between insulin resistance and β-cell function in diabetic patients and individuals with impaired glucose tolerance.It has provided data on the current prevalences and related risk factors of osteoporosis,chronic kidney diseases,and thyroid nodules in Chinese adults with abnormal glucose metabolism.This large cohort constitutes an important platform and a rich resource for investigators from different fields to answer important research questions concerning risk factors,mechanisms,early detection,and management of metabolic diseases.