Nowadays,aging is the general trend of population development in the world.Type 2 diabetes is one of the most common chronic diseases in the elderly.Because of the atypical symptoms and signs,accompaniment of chronic cardiovascular disease and vulnerability to low blood glucose in the elder patients with diabetes,we should to make safe,effective,and individualized therapeutic programs for them.This paper will review the current prevalence,characteristics,and oral drug selection among elderly individuals with T2DM.

11? Hydroxysterold dehydrogenases (11?-HSDs )catalyse the interconversion of active glucocorticoids(cortisol,corticosterone )and their inert 11?-keto derivatives(cortisone,11-dehydrocorticosterone)They play an important role in regulating the local glucocorticoids activities.Glucoeorticoids can induce insulin resistance.The alteration of 11?-HSD activities in tissues such as liver ,adipose tissue, is closely relevant to some common disorders,including obesity and type 2diabetes mellitus.

hydroxysteroid dehydrogenase (11? HSD) catalyzes the interconversion of cortisol with its inactive metabolite cortisone. The congenital deficiency of 11? HSD2 induce hypertension and hypokalemia. This disorder is called "Apparent Mineralocorticoid Excess(AME)". Glycyrrhizic acid and other endo and xenobiotics have been found to inhibit the activity of 11? HSD and cause excess mineralocorticoid effects that is similar to AME. The decrease in 11? HSD activity is related with the acquired and congenital hypertention.

Peroxiredoxins(Prxs) are a family of antioxidant protein that have been identified in prokaryotes and eukaryotes. As antioxidants, Prxs protein contains an active site cysteine that is sensitive to oxidation by H 2 O2, eliminate active oxygen that exist in normal tissues and cells, protect cells from oxidative damage induced by reactive oxygen species ( ROS). Prxs protein is a known free radical scavenger, and has been shown to play a role in several diseases. In this review, recent advances on the study of Prxs protein family and tumor related diseases are reviewed, which is expected to provide new ideas for the diagnosis and treatment of the related clinical diseases.

Autoimmune disease is a condition arisen from an abnormal immune response to the tissue cells itself, its precise mechanism remains unknown, and the failure to distinguish self from non-self is often termed a breach of tolerance and is the basis for autoimmune illness. The tumor necrosis factor-α (TNF-α) induced protein 8 like-2 (TIPE2) is a newly discovered member of TNF-α induced protein 8 (TNFAIP8) family which is an essential negative controller of both innate and adaptive immunity. It has been documented that marked expressions of TIPE2 are evident in various autoimmune diseases, including autoimmune hepatitis (AIH), primary biliary cirrhosis (PBC), myasthenia gravis (MG) and systemic lupus erythematosus (SLE), which appear to be closely related to the severity, progression as well as prognosis of the illness, thereby contribute to the pathogenesis of autoimmune diseases. Deficient expression of TIPE2 might contribute to the hyper-reactivity of auto-reactive lymphocytes and macrophages, or aggregate inflammatory reaction by prompting high concentration of pro-inflammatory cytokines in peripheral blood, thus, trigger the development and progression of autoimmune diseases. In addition, dysregulation of immune homeostasis could be another latent target involved into the mechanism of autoimmune diseases. The present paper summarized the potential role and its mechanism of TIPE2 in the development of autoimmune diseases.

Infectious diseases are resulted from the invasion of an organism's body tissues by multiple disease-causing agents. It has been demonstrated that the occurrence and development of infectious diseases are closely associated with the functional status of immune system. Cytokines play significant roles in modulating the host immune response to the clearance of pathogenic microorganisms and maintaining immune homeostasis. Interleukin-35 (IL-35), as a newly identified member of IL-12 family, exerts suppressive effect on immune response by means of a specific pattern. With the progress of research in recent years, IL-35 might serve as an essential contributor in the immunopathogensis of vast infectious diseases, including hepatitis B, sepsis, tuberculosis and parasite infection, which simultaneously appear to be closely related to the severity, progression as well as prognosis of the illness. Apparently, IL-35 is regarded as a potent and promising anti-inflammatory cytokine in clinical application; its potential value may shed light on the therapeutic strategies for infectious diseases. Herein, we mainly review the potential role and its mechanism of IL-35 in the pathogenesis of infectious diseases.

Objective To summarize the modified clinical technique and experience of simultaneous kidney-pancreatic transplantation (SKPT) with enteric drainage(ED). Methods Two patients with insulin-dependent diabetes mellitus and end-stage renal disease underwent SKPT with enteric drainage of exocrine secretions.The patients were treated with quadruple therapy including antithymocyte globulin (ATG) induction therapy,prednisone,FK506,and Mycophenolate-Mofetil(MMF), as maintenance immunosuppression. Results The two patients became insulin-independent after treated by small dose insulin for 5～10 days and Scr,BUN became normal 3～5 days after the operation.Until now all the grafts of the patients functioned well. Conclusions ED-SKPT is more effective than simultaneous kidney-pancreatic transplantation with bladder drainage (BD-SKPT).ED-SKPT is an effective method for treating type Ⅰdiabetes mellitus with uremia.Finer allograft and nicer HLA-typing can decrease complications.

Objective To retrospectively evaluate effects of early dynamization of interlocking intramedullary nail on union of tibial shaft fractures.Methods From January 2002 to Septemher 2004,75 patients with tibial shaft fractures were treated in our department with internal fixation using static interlocking iutramedullary nails.Early dy- namization(6 to 10 weeks postoperative)was adopted in 32 patients (the dynamic group) according to the fracture con- ditions,while the other 43 patients were treated without early dynamization (the non-dynamic group).The healing time of fractures and the rate of delayed union in both groups were documented.Results All the cases were followed up for a mean duration of 6.5 months (range,4 to 13 months).The mean healing time was 115.6 days (range,105 to 126 days) in the dynamic group and 124.5 days (range,119 to 133 days) in the non-dynamic group.The difference was statistically significant between the two groups (P＜0.05).There were two cases (6.2%) of delayed union in the dynamic group and four (9.4%) in the non-dynamic group.The difference was not significant (P＞0.05). Conclusion Early dynamization of interlocking intramedullary nail can promote union of tibial shaft fractures.

Objective To investigate the effect of stress induced by fear on germ cells apoptosis in rat's testis. Methods 36 SD rats were randomly assigned to acute stress group, subacute stress group, chronic stress group and control group, respectively. The model of the stress rat induced by fear was reproduced. The levels of caspase-3 mRNA and bax /bcl-2 mRNA expression in rats' testis were determined by fluorescent quantitative RT-PCR. The apoptosis of spermatogonic cell, primary spermatocyte, secondary spermatocyte and spermatid was identified by TUNEL. Results Caspase-3 mRNA, compared with that in control group, was expressed highly in the subacute stress group (5.34?1.13 vs 3.67?0.34, P0.05). The ratio of bax /bcl-2 mRNA, compared with that in the control group, was increased significantly in the subacute stress group (2.68?0.86 vs 1.60?0.42, P0.05). Compared with that in control group (1.50?0.58), the apoptotic index of germ cells was higher in the subacute stress group (10.50?1.29, P0.05). Conclusion Stress induced by fear plays an important role in inducing germ cells apoptosis, and caspase-3, bax and bcl-2 were involved in this process.

BACKGROUND:Spiral acetabular prosthesis has good stability during total hip arthroplasty.
OBJECTIVE:To observe the early therapeutic effect of Zweymüler spiral acetabular prosthesis in total hip arthroplasty for patients with developmental dysplasia of the hip.
METHODS:Totaly 38 patients (48 hips) with developmental dysplasia of the hip received total hip arthroplasty with Zweymüler spiral acetabular prosthesis from January 2011 to June 2013 were selected. The clinical effect was observed after the operation.
RESULTS AND CONCLUSION: A total of 38 patients were folowed up for 21-46 months (averagely 42.3 months). One case suffered from deep venous thrombosis. Harris scores and Charnely scores apparently increased after surgery compared with that before surgery. The mean length of the osteotomy was 2.42±0.48 cm, and the mean extended length of the affected limb was 4.58±1.15 cm. X-ray films showed that there was no disunion of the osteotomy, no subsidence and loosening of prosthesis. The position of the acetabulum was suitable. The healing time of bone graft was 3-11 months (averagely 5.3 months). The coverage of the acetabular component was 92.5%, with a good initial stability, and the excelent rate of the operation was 90%. The satisfaction rate of patients was 84%. These results indicate that the Zweymüler spiral acetabular prosthesis has the advantages of reasonable design, good initial stability, low loosening rate and high satisfaction degree. However, the number of cases of this study was relatively smal, the folow-up time was short, and only the short-term effect was evaluated. Thus, the midterm and long-term effects need to be observed by the folow-up evaluation.