[Summary] Good glycemic control can delay the occurrence and development of diabetic complications. Artificial pancreas, which autonomously mimics the physiologic glucose control of pancreas islet, regulates the blood glucose subtly. Artificial pancreas seems to be one of the promising glucose control approaches.

Objective To discuss the expression and the related factors of E-selectin in insulin-resistant(IR)rat endothelium. Methods Wistar rats were randomly divided into 3 groups: high fat feed,high fructose feed and the control feed(HF group,HG group and NC group). IR rat model was established by high fat feeding or high fructose feeding for 4 weeks and was evaluated with euglycemic clamp technique. E-selectin protein expression was detected by Western-blot analysis. Results The expression of E-selectin protein in vessel endothelium was increased in HF group and HG group compared with that in NC group (P<0.01), and higher in HF group than in HG group (P<0.05). E-selectin protein expression was correlated significantly with TG, FFA, FIns and HOMA-IR in HF group and HG group (P<0.05). Conclusions IR may cause the increased expression of E-selectin in endothelium of rats fed with high fat or fructose.

Dysphagia is a common problem in cerebrovascular diseases such as intracerebral hemorrhage , cere-bral infarction and so on . When food or liquid passes through the larynx , it may cause intensively bucking . Nowadays there are no specific drugs , but the swallowing function will progress after acupuncture and rehabili-tation therapy . We searched and analyzed articles on acupuncture and rehabilitation therapy in the treatment of post-stroke dysphagia in recent three years . It showed that both of them were effective for the swallowing function of patients. The combination of both therapies receives better effects. However, there are still argu-ments in the clinical using opportunity of acupuncture and rehabilitation therapy for the treatment . There are so many methods in the treatment of this disease by acupuncture. Hence, there are no efficient contrasts or standard therapies. In the future, the clinical practice should pay more attention to the therapy of high quality and optimization in order to promote its clinical application .

Objective To study the impairment and the expression of receptor of advanced glycation endproduct (RAGE) in cultured rat glomerular mesangial cells ( GMC ) induced by constant and intermittent high glucose, and to investigate the pathogenesis of diabetic nephropathy. Methods After being cultured under constant and intermittent high glucose with different concentrations for 24 and 48 hours, the morphological changes of rat mesangial cells were observed, the proliferation of GMC was detected by MTT assay, the activity of superoxide dismutase (SOD)and the level of malondialdehyde (MDA)in supernatant were measured by spectrophotometer,and the expressions of RAGE mRNA were evaluated by RT-PCR. Results ( 1 ) Compared with the control group,the cellular morphology was changed in case of constant and intermittent high glucose. The damage of GMC with intermittent high glucose concentrations was more serious. (2)The activity of SOD was decreased and the level of MDA was raised in case of intermittent high glucose concentrations compared with the constant high glucose concentrations (P＜0.05). (3)The expression of RAGE mRNA with intermittent high glucose concentrations was significantly higher than that with constant high glucose concentrations ( P＜0. 01 ). Conclusions The damaging effects and increased expression of RAGE in cultured rat GMC induced by blood glucose fluctuation was much worse than that with constant high glucose. The blood glucose fluctuation may be one of the causes that induce diabetic nephropathy.

Objective To observe the therapeutic efficacy of the Chinese medical herb decoction qu yin tang combined with narrow-band ultraviolet B (NB-UVB) phototherapy on psoriasis vulgaris, and to investigate its influ-ence on osteopontin (OPN) and vascular endothelial growth factor (VEGF) in serum. Methods Sixty patients with psoriasis were randomly divided into a treatment group and a control group. The treatment group was treated with qu yin tang and NB-UVB; the control group was treated with qu yin tang only. The levels of OPN and VEGF in serum were detected in both groups before and after treatment using an enzyme-linked immunosorbent assay (ELISA). Twenty healthy persons' serum samples were taken as controls. At the same time, any changes in psoriasis area and severity index (PASI) scores in the two groups were recorded and compared. Results After 8 weeks of treatment, PASI scores and levels of OPN and VEGF had been reduced significantly in both groups, and there was a significant difference between the treatment group and the control group. Conclusions Chinese medical herbs combined with NB-UVB phototherapy is a safe and effective method for the treatment of psoriasis. The results suggested that OPN and VEGF may play an important role in the pathogenesis of psoirasis vulgaris.

Objective To investigate the geographical distribution of plague host animals in residential areas and the association between plague and its distribution pattern in Yunnan Province.Methods A systematic investigation on fauna and community ecology of rodents was carried out in residential areas of 17 counties(cities) of Yunnan Province,southwestern China with different longitude,latitude and elevation from May 2007 to November 2012.The characteristics of the spatial distribution of flea communities along environmental gradients were analyzed using community structure indexes.Results A total of 390 small mammals were trapped in seventeen counties (cities),and the mammals were classified into 11 species and 7 genus in 4 families.Among all small host mammals,Rattus tanezumi,Rattus nitidus and Rattus norvegicus were dominant species of host animals in residential areas,accounting for 33.85％ (132/390),20.77％ (81/390) and 16.92％ (66/390),respectively.The horizontal distribution of rodents showed that Rattus tanezumi was the widest species in residential areas,which was found at the longitude 98°-105°,followed by Rattus norvegicus,Rattus yunnanensis and Mus musculus.The vertical and latitudinal distributions of rodents were similar in residential areas.Rattus tanezumi was also the widest distributed species,which was observed at the latitude 21°-＜ 28°N and at the altitude 500-＜ 3 500 m; the constituent of Rattus tanezumi showed similar trends of leaning peak curves,first gradually increasing and then decreasing with the increase of latitude and elevation; Rattus tanezumi gradually changed into Rattus nitidus and Apodemus chevrieri,et al.The richness spatial distribution patterns of host animals showed similar trends of leaning peak curves which gradually increased and then decreased with increasing of longitude and latitude; the highest richness was observed at the longitude 98°-＜ 101°E and at the latitude 23°-＜ 28°N.While,the richness spatial d istribution patterns of host animals were relatively poor in the low or the high altitude range.The highest richness was observed at the altitude between 1 000-＜ 1 500 m and 2 000-＜ 2 500 m.Conclusions All spatial patterns of indoor host animals have shown an aggregated spatial distribution in Yunnan Province.Moreover,important environmental factors such as longitude,latitude,and altitude play a substantial role on the distribution patterns of indoor host animals among various focus,therefore directly impact on the modes of prevalence and transmission of plague.

Objective To study the feasibility and safety of trial of labor after cesarean section (TOLAC). Methods Retrospective analysis of five medical center of Guangdong province from January 2011 to December 2015 hospitalized delivery information, compare the same scar TOLAC (research group) with the scar pregnancy (control group) pregnancy outcomes, to study the feasibility and safety of TOLAC. Results (1)During 2011-2015, total delivery 95 600 cases in five medical center, 13 824 cases of thme with uterine scar pregnancy, including 12 027 cases elective repeat cesarean section and 1 797 cases (13.00%, 1 797/13 824) with scar uterus vaginal trial of labor. Among 1 308 cases of vaginal delivery,the success for trial of labor rate was 72.79% (1 308/1 797). From 2011 to 2015, there were increased rate of pregnancy after cesarean section, which were respectively 10.71%, 13.28%, 14.45%, 15.54%and 16.98%. The will of vaginal birth were rising and the rate were respectively 11.85%, 12.25%, 13.49%, 13.82%and 12.93%. (2) There were 489(27.21%,489/1 797) cases of scar uterus maternal emergency cesarean section in the trial of labor, reason for“social factors”require for cesarean delivery have 68 cases, the percentage was 13.91% (68/489), compared with control group (7.18%, 206/2 869), the difference was statistically significant difference (χ2=27.356,P=0.000). Doctors diagnosed as“aura uterine rupture”in the labor was 11.86% (58/489), compared with that in control group (1.43%, 41/2 869), the differences were statistically significant difference (χ2=1 578.223,P=0.000). (3) The incidence of uterine rupture of the research group(0.74%,9/1 211)was significantly higher than that of control group (0.01%,2/31 200;χ2>2 000,P=0.000). The incidence of postpartum hemorrhage in research group was 6.94% (84/1 211), compared with that in the control group (3.05%, 951/31 200), there was statistically significant difference (χ2=16.328,P=0.000). While, there were no statistical significancefor the labor time limit,birth rate of severe asphyxia and neonatal birth weight average differences between two groups (P>0.05). Conclusions The rate of pregnancy after cesarean section is increasing year by year, and the will of vaginal birth is increasing, while it still are generally low. TOLAC is safe and feasible, but also significantly higher risk, strictly labor monitoring and can proceed fast cesarean delivery in delivery room is an important guarantee of safe delivery.

Objective To evaluate the efficacy and safety of short-term sensor-augmented insulin-pump (SAP) therapy for poorly controlled patients with type 1 diabetes mellitus (T1DM).Methods Sixty T1DM patients with glycosylated hemoglobin (HbA1c)>9.0% were randomly assigned to 2 groups treated with SAP or multiple daily insulin injection ( MDI) for 6 days, then all patients converted to MDI therapy. Results Compared with MDI group and before therapy, the mean blood glucose concentration ( MBG) , SD of blood glucose, mean amplitude of glycemic excursion ( MAGE) and 24-h area under curve at 10.0 ( AUC10.0 ) levels in SAP group significantly decreased after 6-day therapy ( compared with MDI group:t=1.761,P=0.028, t=2.569,P=0.037, t=2.712,P=0.020, t=2.985,P=0.014, compared with before therapy:t=3.128,P=0.006, t=2.689,P=0.024, t=2.966,P=0.013, t=3.076,P=0.009);while there was no difference in 24-h area under curve at 3.9 (AUC3.9) between groups (P>0.05).After 1 month follow-up HbA1c levels decreased in SAP group (t=2.344,P=0.023) and were significantly lower than those in MDI group (t=1.844, P=0.035).There was no difference in daily insulin dosage, fasting C peptide (FCP) and postprandial 2h C peptide (2hCP) between two groups (P>0.05).Age (t=2.125, P=0.012) and SAP therapy (t=3.376, P=0.009) were independently correlated with the HbA1c after 1 month.Conclusion Short-term SAP therapy is effective and safe for poorly controlled T1DM patients with rapid glucose lowering and glycemic excursions reduction.

Objective:To investigate the value of pericoronary adipose tissue histogram parameters based on coronary CT angiography (CTA) images for the differentiation of acute coronary syndrome and stable coronary artery disease.Methods:The clinical data and CTA images of 93 patients with coronary CTA examination in Suzhou Kowloon Hospital from 2013 to 2018 were analyzed retrospectively. There were 39 patients with acute coronary syndrome (acute coronary syndrome group) and 54 patients with stable coronary artery disease (stable coronary artery disease group). A region of interest (ROI) was drawn around the stenosis of the coronary arteries, with CT attenuation ranging from-190 to -30 HU to exclude non-adipose tissue. The CT attenuation of ROI excluding non-adipose were measured and histogram analysis was performed. The obtained parameters included the mean value, median value and the 5th, 10th, 45th, 55th, 70th and 95th percentiles. The differences in histogram parameters between the two groups were compared, and then the value of each parameter in differentiating acute coronary syndrome and stable coronary artery disease was evaluated based on receiver operating characteristic (ROC) analysis. The stepwise regression of multivariate logistic regression analysis was used to identify the useful features and establish the final prediction model. The ROC curve of the final model was calculated and its value was analyzed.Results:The mean, median and the 5th, 10th, 45th, 55th,70th and 95th percentile differences between the acute coronary syndrome group and the stable coronary artery disease group were statistically significant (all P<0.05). The ROC curve for the median and the 95th percentile had the same area under curve (AUC) of 0.73. The sensitivity, specificity and AUC of the diagnostic model established by multiple logistic regression were 82.1%, 89.1% and 0.90 respectively. Conclusion:CT attenuation histogram of pericoronary adipose tissue is of high value in differentiating acute coronary syndrome from stable coronary artery disease.