Objective To evaluate the possible relationship between IGF-Ⅱand peripheral neuropathy in type 2 diabetes.Methods Seventy-one type 2 diabetic patients without peripheral neuropathy(Group A),Seventy-seven patients with peripheral neuropathy(Group B)and thiry healthy subjects(Group C)were recruited.Serum IGF-Ⅱwas determined in all subjects.Other clinical parameters(fasting plasma glucose、fasting plasma insulin,et al)and nerve conduction velocity were determined in Group A and Group B.Results Group B had significantly lower levels of IGF-Ⅱ,compared to GroupA and Ⅲ(P

Aldose reductase (AR) mRNA level in peripheral blood mononuclear cells was assayed by RT-PCR. There was a positive correlation between PBMC AR mRNA level and urinary albumin excretion rate in type 2 diabetic patients. The result suggests that AR activity is related to the pathogenesis of diabetic nephropathy.

Objective To investigate possible independent association between metabolic syndrome (MS) and obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods According to polysomnography (PSG) examination, 82 obese patients were divided into OSAHS group (n = 55) and non OSAHS group (n = 27) and 30subjects with normal weight were recruited as the control group. PSG parameters such as AHI (apnea hyponea index), oxygen saturation (Spo2,) in obese patients were measured. MS-associated parameters, such as fasting blood glucose (FBG), fasting insulin (FINS), plasma lipid profile, insulin homeostasis model assessment of insulin resistance (HOMA-IR) and blood pressure, height, body weight, waist circumference, were measured in all cases. The prevalence of MS and the parameters were compared among different groups. The correlations between them were analyzed. Results The prevalence of MS in obese patients with OSAHS was significantly higher than that in obese patients without OSAHS (69.09% vs 37.04%, P <0.01). Systolic blood pressure and diastolic blood pressure (DBP), FBG and HOMA-IR were higher in subjects with OSAHS than those without OSAHS (P <0.05 or P <0.01). Multiple stepwise regression showed that DBP was negatively correlated with Spo2, FINS and HOMA-IR were positively correlated with AHI. Conclusion OSAHS is found to be independently associated with MS, which may be a risk factor of cardiovascular disease and other systemic diseases.

Diabetic model of SD rats was induced by streptozotocin injected intraperitoneally. Transforming growth factor (TCF)-?1 mRNA level was significantly decreased in renal cortex of diabetic rats by treatment of Pioglitazone. The result suggests that the protection of Pioglitazone against diabetic nephropathy seems to be related to the decrease of TGF-?1 gene expression in renal cortex.

BACKGROUND:In order to avoid distal arterial embolism fol owing mechanical thrombectomy, micro-bal oon catheter temporary isolation is applied to prevent thrombus shedding.
OBJECTIVE:To investigate the safety and feasibility of adopting the micro-bal oon catheter technique in treatment of the hyperacute cerebral infarction. The micro-bal oon catheter technique can temporarily block the artery blood flow and isolate the embolism location fol owing mechanical thrombectomy and aspiration combined with thrombolysis.
METHODS:Ten beagle dogs were included in this study. Under general anesthesia, the micro-bal oon catheter was delivered to the dominant vertebral artery through the femoral artery in al the dogs and it was fil ed and temporarily blocked the blood flow. Then the autologous thrombus was injected through the micro-catheter into proximal vertebral artery to make a thrombosis model. Al the dogs were equal y divided into two groups according to the embolectomy method:control group (receiving pure stent embolectomy, n=5) and experimental group (n=5). The experiment group was disrupted and aspirated thrombus combined with the drug thrombolysis after temporarily blocking out the blood flow and isolating the target artery by micro-bal oon catheter technique. After treatment, two groups underwent digital subtraction angiography to review the vertebral artery recanalization after different embolectomy methods. The hemodynamic status was evaluated through the thrombolysis in cerebral ischemia grade. Al the dogs were scanned with magnetic resonance diffusion weighted imaging before modeling and at 12 hours after the thrombectomy. The animals were kil ed to perform pathological examination after magnetic resonance diffusion weighted imaging (12 hours after the thrombectomy). The vessel recanalization rates and complications were calculated in the two groups.
RESULTS AND CONCLUSION:The thromboembolism model was successful y established in the dominant vertebral artery of al the 10 beagle dogs. In the control group, the vertebral arteries were completely successful recanalized in two dogs and were partly recanalized in three dogs, while the vertebral-basilar and intracranial arteries in one dog showed multiple smal punctate fil ing defects with poor intracranial arterial development and contrast agent reflux. At 12 hours after embolectomy, the magnetic resonance diffusion weighted imaging showed slightly high signal intensity at the left temporoparietal lobe and the pathologic examination suggested thrombosis in the cerebral artery lumen of the left temporal lobe. In the experimental group, the vertebral arteries in five dogs were completely recanalized without infarction. The revascularization rate in the experimental group was significantly higher than that in the control group (P<0.05). Experimental findings indicate that, the application of disruption and aspiration thrombus combined with the drug thrombolysis after temporarily blocking the blood flow and isolating the target artery by micro-bal oon catheter technique in treatment of hyperacute cerebral infarction, can effectively prevent the smal embolus exfoliating, which can cause distal embolization. Thus, the micro-bal oon catheter technique is a safe, effective and relatively inexpensive interventional embolectomy.

Objective To evaluate the curative effect and optimal indications of reformed percutaneous lumbar diskectomy (RPLD) for the treatment of lumbar disc herniation.Methods One handred and thirty-three patients with lumbar disc herniation were treated by RPLD, of them, 20 cases were lumbar disc extrusion and 113 cases were lumbar disc protrusion. After the procedure, 85 patients underwent flush of intervertebral space with antibiotic saline and 48 patients underwent 10 ml(40?g/ml) medical ozone-injection inside the disc to prevent infection. All patients were followed up over the course of 3 months. The therapeutic effect was evaluated according to the MacNab criteria. Results All 133 cases underwent RPLD were successful. The total efficacy was 81.9%, There were no serious complications after operations. Conclusion RPLD is an effective method in the treatment of lumbar disc herniation. Both intradiscal ozone-injection or intradiscal antibiotic saline flush after RPLD can reduce the opportunity of infection.

Objective To ameliorate the percutaneous lumbar discectomy(APLD)for improving the effectiveness and amplifying the indicative range of PLD.Methods To ameliorate percutaneous punctured route based on classic PLD and discectomy of extracting pulp out of the herniated disc with special pulpforceps. The statistical analysis of the therapeutic results on 750 disc protrusions of 655 cases undergone APLD following up from 6 to 54 months retrospectively. Results The effective ratios were excellent in 40.2%, good for 46.6% and bad of 13.3%. No occurrance of intervertebral inflammation and paradiscal hematoma, there were only 1 case complicated with injuried cauda equina, and 4 cases with broken appliance within disc.Conclusions APLD is effective and safe, not only indicative for inclusion disc herniation,but also for noninclusion herniation.

Objective To investigate the current status of type 2 diabetic patients who failed to achieve the glycemic control target, and provide theoretic evidences for making corresponding strategies. Methods The 2 diabetic patients who failed to reach the glycemic target were recruited from 181 hospitals in 26 cities and received a standard questionnaire, the conditions of their blood glucose level, lifestyle intervention, blood sugar monitoring, and drug therapy were recorded. Totally 3 861 questionnaires with complete information were collected. And the causes which account for glycemic control status were analyzed. Results Among these patients, the mean HbA1c was 7.9%, the mean fasting plasma glucose was 8.2 mmol/L, and the mean postprandial plasma glucose was 11.5 mmol/L. Only 25.6% of patients take their diet control strictly as prescribed and 44. 5% of patients have little exercise. 35. 8% and 47.8% of patients did not monitor their fasting and postprandial plasma glucose,respectively. Glycemic control in the patients aged ＞ 60 years was similar to the younger patients, but the hypoglycemia incidence in the elder group reached 35.5%, which was higher than those in the other 2 groups (20.8% and 21.4%, both P＜0. 05 ). The proportion of patients with mono-therapy and combination therapy was 46. 1% and 51.7%, while the proportion with combination therapy rose in the patients aged ＞60 years (58.7%;Compared with the other age-groups, all P＜0.05 ). 75 % of patients have adjusted their drug administration regimen since initial treatment. Conclusions Inadequate or inappropriate drug therapy regimen is a major cause responsible for this poor glycemic control status. In addition, the unhealthy life styles, insufficient blood sugar monitoring, and poor compliance were also important causes. Thus, for these patients, it is necessary to further enhance patients' education, to improve life style intervention, as well as to select more effective, safer, and compliant drug therapy regimens. Finally, the glycemic control target for the elder patients should be more flexible.

Objective:To investigate the efficacy of microsurgical treatment in cavernous sinus tumors.Methods:The clinical data of 87 patients with cavernous sinus tumor treated by microsurgery from January, 2010 to August, 2019 were analysed retrospectively. The surgical approaches and microsurgical skills for common tumors in Cavernous Sinus region were discussed. The follow-up included outpatient and telephone follow-ups, and the follow-up results were evaluated by KPS score.Results:Among the 87 cases, 57 were totally resected (65.5%), 14 were subtotal resected (16.1%) and 16 were major resected (18.4%). Hospitalisation ranged from 14 to 98 days, with an average of 29 days. Postoperative complications occurred in 30 cases with cranial nerve injury, 2 brain stem injury, 4 postoperative bleeding, 5 cerebrospinal fluid leakage, 4 infection, 1 Pituitary damage and 1 death. Prognosis and follow-up analysis showed 68 cases with KPS>60 and 66 with KPS>80 at 1 month after surgery; 74 with KPS>70 and 72 with KPS>80 at 3 months after surgery; 78 with KPS>80 by 12 months after surgery. During the follow-up period of 6-120 months, 3 cases died. Recurrence: 6 of incomplete resection of meningioma, were in 1-6 years after the surgery, 4 of incomplete resection of schwannoma in 1-8 years, 2 of pituitary adenoma respectively in 13 and 16 months after the surgery. There was no recurrence after reoperation. Two cases of chondrosarcoma, 3 of chordoma and 3 of germinoma were treated with radiotherapy, and during the follow-up, there was no progress of the focus. No tumor progression or recurrence was found in other cases during follow-up.Conclusion:Surgery of cavernous sinus tumor is difficult due to frequent postoperative complications. Reasonable preoperative plan, surgical approach and precise microsurgical techniques are the keys in reduction of postoperative complications and in the improvement of prognosis.

[Summary]_ Transient neonatal diabetes mellitus is a kind of rare special types of diabetes. It should be distinguished from type 1 diabetes. Genetic analysis can be used to define the subtype of neonatal diabetes mellitus, which helps us to select the most appropriate treatment and to predict the disease recurrence. Sulfonylureas is able to improve insulin secretion in most patients with transient neonatal diabetes mellitus and provide effective glycemic control. A case of transient neonatal diabetes mellitus is reported in order to call attention to the diagnosis and treatment of this disease.