Neonatal diabetes mellitus(NDM)occurs within the first 6 months of life. Depending on clinical outcomes,it is classified into transient neonatal diabetes mellitus(TNDM)and permanent neonatal diabetes mellitus (PNDM). TNDM,which accounts for 50% of NDM goes into remission after treatment for an average period of 12 weeks,but relapse in puberty and early adulthood. PNDM,on the other hand,is a lifelong disease without remission. The clinical features of TNDM and PNDM overlap,and the typing is based on clinical remission on follow - up. More than 20 pathogenic genes have been identified in PNDM,of which the most common are KCNJII and ABCC8 encoding the Kir6. 2 and SUR1 subunits of KATP channel accounting for 50% . TNDM is caused by defects associated with overexpres-sion of paternally expressed genes in the imprinted region of chromosome 6q24 in 70% cases. About 26% of the defects contain mutations in KCNJII,ABCC8,INS or HNFIB. In vitro and clinical studies suggest that treatment with oral sul-fonylurea can close KATP channel and improve glycemic control and neuropsychological development. However,10% of patients with KCNJII and 15% ABCC8 mutations fail to achieve glycemic control when insulin therapy is switched to o-ral sulfonylureas. Therefore,molecular diagnosis is vital not only in accurate typing but also for better prognostication.

The paper described the concept of evidence-based medicine and its guiding role in clini-cal practice and scientific research. It emphasized the importance of teaching evidence-based medicine in clinical medicine teaching of medical college students, and put forward some suggestions on how to carry out evidence-based medicine teaching among undergraduate students. In the course of undergraduate study, students should have preliminary grasp of how to apply the theory of clinical epidemiology to evaluate the evidence of clinical research so that they could evaluate the authenticity, importance and applicability of the research evidence . Besides , they could correctly understand and apply the evidence of evidence-based medicine in clinical practice in the future, and at the same time cultivate their scientific research thinking and innovative ability.

The insulin sensitivity in hypertensive patients with normal glucose tolerance (NGT), impaired glucose tolerance (IGT) and type 2 diabetes mellitus (DM) and the insulin resistance (IR) under the disorder of glucose metabolism and hypertension were studied. By glucose tolerance test and insulin release test, insulin sensitivity index (ISI) and the ratio of area under glucose tolerance curve (AUCG) to area under insulin release curve (AUCI) were calculated and analyzed. The results showed that ISI was decreased to varying degrees in the patients with hypertension, the mildest in the group of NGT with hypertension, followed by the group of IGT without hypertension, the group of IGT with hypertension and DM (P = 0). There was very significant difference in the ratio of AUCG/AUCI between the hypertensive patients with NGT and controls (P = 0). It was concluded that a significant IR existed during the development of IGT both in hypertension and nonhypertension. The increase of total insulin secretion (AUCI) was associated with nonhypertension simultaneously. IR of the hypertensive patients even existed in NGT and was worsened with the deterioration of glucose metabolism disorder, but the AUCI in the HT group changed slightly. A relative deficiency of insulin secretion or dysfunction of beta-cell of islet existed in IGT and DM of the hypertensive patients.
Diabetes Mellitus, Type 2/metabolism ; Glucose Intolerance/complications ; Glucose Intolerance/metabolism ; Hyperinsulinism/etiology ; Hyperinsulinism/metabolism ; Hypertension/complications ; Hypertension/*metabolism ; *Insulin Resistance

Objective To analyze the chemical components of clove oil before and after ?-cyclodextrin inclusion.Methods GC-MS conditions were as follows: DB-1 Capillary gas chromatographic column,programmed temperature rising from 60 ℃ to 230 ℃ at the rate of 10 ℃ /min;split ratio being 1 ∶ 50,Injector port temperature at 230 ℃,and Flame Ionization Detector(FID) temperature at 230 ℃.The components were detected by MS detector.Results GC-MS analysis showed that the main components of clove oil did not changed before and after inclusion,but the proportion of the components had been changed.Conclusion ?-cyclodextrin inclusion have effects on the proportion of clove oil components.

Alzheimer′s disease (AD) is a degenerative neurodegenerative disease of the central nervous system. The disease is concealed. Patients often experienced several years or even more than ten years of course evolution from the beginning of pathological changes to clinical symptoms. Once entering the stage of dementia, there is no ideal drug to reverse the disease. In order to improve the efficiency of early diagnosis, the research on early biomarkers of the disease has become a hot topic in recent years. In addition to the Aβ and tau, microRNAs have been discovered as potential biomarkers of AD.

0.05). Conclusion:After Ni-Cr-Based porcelain-fused-to-metal crown application, the metal ion can be released and absorbed by human body. But the content is almost harmless to human body.

BACKGROUND: Although nickel and chromium are essential elements of human body, over high concentration of them will produce many adverse effects to human body, therefore biological safety of nichrome material for dental restoration deserves attention.OBJECTIVE: To observe the changes of nickel and chromium content at 6 months and 1 year after porcelain-fused-to-nichrome crown restoration, and compare to healthy controls to investigate the long-term safety of nichorme in oral cavity.DESIGN, TIME AND SETTING: A case-control observation was performed between January 2006 and December 2007 at the First Affiliated Hospital of Hebei North University, Zhangjiakou, Hebei Province, China.PARTICIPANTS: Sixty patients who visited Department of Stomatology, the First Affiliated Hospital of Hebei North University, between January and December 2006 were included in test group, including 28 male, 32 female, the mean age was 40 years. Each of them had 3 anterior maxillary teeth restored by porcelain-fused-to-nichrome crowns, without other metal fillings or protheses. Sixty healthy cases visited the hospital at the same time were used as control, including 30 male, 30 female, the mean ages was 39 years.METHODS: Fasting venous blood of participants in two groups was harvested sterilely at 6 months and 1 year after test group restoration, serum nickel and chromium content were determined using graphite furnace atomic absorption spectrometry.MAIN OUTCOME MEASURES: ① Serum nickel content changes in test and control group. ②Serum chromium content changes in test and control groupRESULTS: All cases were involved in result analysis. ① Serum nickel content changes in test and control group: At 6 months postrestoration, there was no significant difference in serum nickel content between test group and control group (P>0.05). At 1 year after restoration, serum nickel content of test group was significantly higher than that of control group (P<0.05). ② Serum chromium content changes in test and control group: There was no significant difference in chromium content between test and control group at 6 months and 1 year after test group restoration (P>0.05).CONCLUSION: Nickel and chromium released from porcelain-fused-to-nichrome crowns after restoration under oral environment, serum nickel content had an increasing tendency with the prolongation of restoration time, but in small quantity and within biosafety range, to identify whether the increasing tendency will increased continuously with the prolongation of restoration time needs long-term follow-up.

Objective To investigate the effect of different speed of perioperative fluid infusion on rate of platelet aggregation during percutaneous coronary intervention. Methods 60 patients accepted percutaneous coronary intervention (PCI) were divided into 2 groups. The control group (n=30) accepted fluid infusion in speed of 1.5~2 ml/kg·h, while the trial group (n=30) with the speed of 6~9 ml//kg·h after coronary arteriongraphy. Their blood pressure, heart beat, rate of platelet aggregation and osmotic pressure of plasma were recorded. Results It was not significantly different in rate of platelet aggregation before and 4 h after operation in the control group (P>0.05), and it was significantly lower 4 h and 1 d after operation in the trial group (P<0.05). Conclusion Fast fluid infusion perioperatively can lower the rate of platelet aggregation, which may improve the success of PCI and reduce the acute thrombosis

Objective To explore the activation of circulating platelet in patients with cerebral infarction(CI) and its correlation with CI.Methods The fibrinogen receptor(FIB-R) and P-selectin were used as molecular marker of circulating platelets, which were analyzed by flow cytometry in 80 healthy persons and 127 CI patients in acute and rehabinating period.Results The FIB-R expression on circulating platelet of CI patients in dangerous period was significantly higher than that in steady period and healthy persons(P0.05).Conclusion The activation of circulating platelet has a close relationship with CI. FIB-R may be a sensitive molecular marker of circulating activated platelet. It will help to evaluate the severe extent of CI and give an anti-platelet treatment as soon as possible to improve the prognosis of CI through monitoring the FIB-R of CI patients successively.

Objective To explore the causes,prevention and treatment of common complications in stone extraction by choledochoscopy after bile duct operation.Methods The clinical data of 165 cases with complications after stone extraction by choledochoscopy in 1379 treated cases during 7 years were analyzed.Results The common unfavorable reactions of nausea,vomiting,abdominal pain and diarrhea occurred in 107 cases,and were alleviated by controlling the amount and rapidity of the infused sterilized water during choledochoscopy.Chills and fever occurred in 25 cases and were controlled by adequate T tube drainage and antibiotics.Bile duct hemorrhage occurred in 11 cases,including automatic hemostasis in 5 cases,hemostasis after infusing thrombin by T tube in 5 cases and hemostasis after infusing thrombin by vein in 1 case.Biliary fistula from sinus tract perforation occurred in 3 cases,and in these,T tube was successtully re-inserted in 1 case and T tube was inserted by reoperation in 2 cases.T-tube tract could not admit the choledochoscope in 19 cases,and were treated by re-choledochoscopy after gradual T-tube dilataton in 12 cases,but the sinus tract close to common bile duct was completely obstructed in 7 cases.Conclusions Choledochoscopic removal of retained stones is a safe procedure but unfavorable reactions and complications are not uncommon.The severe complications,such as bile duct hemorrhage and biliary fistula,should be prevented and appropriately treated.