ADVANCE trial demonstrated that stable intensive glucose control could improve prognosis and the target HbA1c should be 6.5%.While ACCORD and VADT trials suggested aggressive glucose lowering in diabetics at high cardiovascular risk is potentially harmful,tight glucose control yields no significant effect on long duration,poorly controlled patients with complications.DCCT and UKPDS research confirmed benefits of early intensive glucose control could persist due to legacy effect.Steno-2 research showed patients benefit greatly from comprehensive control of risk factors.In sum,early intensive control of risk factors and individualized treatment in diabetics are mainstream therapy.

Objective To investigate the expression of matrix metalloproteinase-8 (MMP-8) in human breast cancers and its relationship with the clinicopathological parameters,evaluate the relevance of MMP-8 levels to metastases in breast cancer.Methods Human specimens were obtained from 50 patients with invasive ductal carcinomas,and 20 normal breast glands were enrolled.Intact clinical parameters were aviliable for all patients.The protein expression of MMP-8 was determined by immunohistocbemistry technology SP.Results The rate of MMP-8 positive breast cancer was significantly higher than that in normal breast glands [68 ％ (34/50) vs 15 ％ (3/20),P ＜ 0.05].The expression of MMP-8 showed a negative correlation with breast cancer staging.The expression of MMP-8 in stage Ⅰ was higher than that in stage Ⅱ and Ⅲ/Ⅳ[94 ％ (15/16),57 ％ (13/23),55 ％ (6/11),P ＜ 0.05].Lymph node negative patients had a higher MMP-8 expression than patients with lymph node metastases [84 ％ (21/25) vs 50 ％ (13/25),P ＜ 0.05].Conclusion MMP-8 expression is associated with human breast cancer metastases and might be involved in inhibiting metastases.

Objective To observe the effect of neuromuscular electric stimulation (NMES) on post-stroke dysphagia (PSD). Methods Two hundred patients with swallowing dysfunction after stroke were randomly divided into a control group with 67 cases and a study group with 133 cases. All patients received pharmacotherapy and swal-lowing training. The study group also received NMES. The study group was sub-divided into unilateral and bilateral cortical stroke sub-groups, an ischemic stroke sub-group and a hemorrhagic stroke sub-group. The swallowing levels of the groups were compared after 2 courses of treatment with NMES. Results After an average of 20 days of NMES treatment, the level of dysphagia and its severity improved significantly. The patients with dysphagia due to unilateral stroke improved, on average, more than those with bilateral stroke. Patients with dysphagia due to ischemic stroke improved more than those with hemorrhagic stroke. Conclusions NMES therapy combined with rehabilitation train-ing can significantly improve swallowing in patients with PSD.

Objective:To observe the effect of timosaponin AⅢon the proliferation of cultured melanoma B16 and A375 cells and nitrite produced from macrophage activation. Methods:MTT assay was adopted to detect the cell growth inhibition. The morphological changes of B16 and A375 cells were observed under an inverted microscope. Nitrite production of activated mouse macrophages induced by lipopolysaccharide ( LPS) plus IFN-γ was measured by Griess assay. Results: Timosaponin AⅢ could significantly inhibit the growth of B16 cells at the concentration of 16 μmol·L-1 after the 48- and 72-hour treatment, and significantly inhibit the growth of A375 cells at the concentration ranged from 4 to 16 μmol·L-1 after the 48-and 72-hour treatment. Shrinkage, vacuoles and necrosis of B16 and A375 cells were observed after the 48-and 72-hour treatment by 16μmol·L-1 timosaponin AⅢ,the other concentration of timosaponin AⅢ showed no notable effect on B16 cells and vacuoles of A375 cells appeared at the concentration from 4 to 16 μmol· L-1. Compared with RAW 264. 7 stimulated LPS plus IFN-γ,timosaponin AⅢ could significant inhibit nitrite production of macro-phage inflammatory cell model at the concentration of 10μmol·L-1(P<0. 01). Conclusion:Timosaponin AⅢcan inhibit the prolif-eration of melanoma B16 and A375 cells and macrophage inflammation,suggesting it has anti-tumor and anti-inflammatory effects . The anti-tumor effect of timosaponin AⅢ may be related to the inhibition of tumor inflammation.

Objective To analyze the risk factors of intracranial infection after neurosurgery and the effect of vancomycin.Methods 28 cases of craniotomy in this study, The First Hospital of Ningbo City from January 2011 to July 2014 during the years after the occurrence of intracranial infection patients as the research object, a retrospective analysis of the age, gender, emergency, basic diseases, mastoid airroom, ventricle drainage, posterior fossa surgery, reoperation and operation time (more than 4h).The clinical data, summarize the risk factors of postoperative intracranial infection in department of neurosurgery and to observe the clinical effect of vancomycin in the treatment of such patients.Result The high risk factors of intracranial infection include: Open mastoid gas room during operation, ireoperation, ventricular drainage and operative time (more than 4h).In 28 cases with intracranial infection after craniotomy, the total effective rate of vancomycin treatment was 100.00%.Conclusion The high risk factors of intracranial infection after operation include open surgery, mastoid room, reoperation, ventricular drainage and longer operation time.Vancomycin is an effective drug in the treatment of intracranial infection in the department of neurosurgery.

Objective To prepare icariin-loaded poly(lactic-co-glycolic acid) (PLGA) nanoparticles (icariin nanoparticles) and analyze their physical and chemical properties,the release of icariin,and the effects on human osteoblast cells in vitro.Methods Icariin nanoparticles were prepared by ultrasonic emulsification and dialysis method and characterized by transmission electron microscopy and particle size analyzer.The release studies in vitro were adopted to evaluate the release-control features.Thiazolyl blue tetrazolium bromide (MTT),alkaline phophatase activity assay,and calcium nodes dyeing were carried out to investigate the effects of icariin nanoparticles on the growth and differentiation of human osteoblast cells MG-63.Results The icariin nanoparticles had spherical shapes and uniform particle size,and the mean size of the nanoparticles was (185.8±5.6) nm.The icariin nanoparticles showed the best property of sustained release and biocompatibility.Meanwhile,the icariin nanoparticles had no effect on the growth of MG-63 ceils,but they promote the differentiation of osteoblast cells by a concentration-and time-dependent manner.Conclusions The icariin nanoparticles prepared by ultrasonic emulsification and dialysis method have a good effect on the differentiation of human osteoblast cells in vitro and are biocompatible.

Objective To explore the difference of immunosuppresive effect between the expanded Stro-1+ and Stro-1-subgroups of human mesenchymal stem cells in vitro. Methods Mononuclear cells (MNCs) were isolated from bone marrow (BM) samples and seeded in a T-75 cm2 tissue culture flask contained with Dexter medium. When 50% confluence was obtained, adherent cells were collected and incubated with anti-stro-1 antibody, and the Stro-1+ and Stro-1-MSCs were further seeded for expansion. The total culture time (median) was 15 days. Cells were then analyzed by flow cytometry. One-way mix lymphocyte reaction (MLR) (1?105 responding cells and an equal number of stimulating cells/well were co-cultured in 96-well plates) and nonspecific mitogenic stimuli phytohemagglutinin (PHA) plus interleukin-2 (IL-2) induced lymphocytes proliferation (PBL 1?105/well were mixed with PHA 10?g/ml and IL-2 500U/ml in 96-well culture plates) were established in vitro. 1?103-3?104 irradiated Stro-1+ MSCs and Stro-1-MSCs were added into the two systems at the beginning of reaction. Immunosuppressive actions of both Stro-1+ or Stro-1-MSCs were compared. Results Adherent cells contained a median of 9% (range 5%-26%) Stro-1+ cells, which expressed higher immunophenotype of MSCs. In both reaction systems, suppressive actions occurred in a dose-dependent fashion when whatever Stro-1+ MSC or Stro-1-MSC were added. However, that the addition of 1?103 Stro-1-cells enhanced rather than inhibited the lymphocyte proliferation in one-way MLR. In the presence of various concentrations of MSCs, Stro-1+ MSCs always showed a significantly increased inhibitory effects in comparison to Stro-1-MSCs (P

35), while the expression level of TGF-?1 in Stro-1-MSC was significant higher than that detected in Stro-1+MSC (2-??Ct=0.39, P

As a stable marker to reflect the average level of blood glucose,HbA1c is very important in glycaemic control evaluation.However,more and more data from evidence based medicine demonstrated that blood glucose fluctuation can also contribute to diabetic complication and prognosis which can not be neglected.Multiple capillary glucose measurements and continuous glucose monitoring are major methods to detect glucose fluctuation.Apart from insulin,various oral anti-diabetic drugs can reduce postprandial glucose excursion.Representative drugs include ?-glycosidase inhibitors,glinides and short-acting sulfonylureas,each have their own way of acting. Abstract:Summ ary:As a stab le m arker to reflect the average level of b lood glucose,HbA1c is very important in glycaem ic control evaluation.However,more and more data from evidence based m ed ic ine demonstrated that b lood glucose fluctuation can also contribute to d iabetic comp lication and prognosis wh ich can not be neglected.Mu ltip le cap illary glucose m easurem ents and continuous glucose mon itoring are m ajorm ethods to detect glucose fluctuation.Apart from insu lin,various oral anti-d iabetic drugs can reduce postprand ial glucose excursion.Representative drugs inc lude?-glycosidase inh ib itors,glin ides and short-acting su lfonylureas,each have the ir own way of acting.

Objective: To study the effect of levosimendan treatment in patients of dilated cardiomyopathy (DCM) with different heart fraction. Methods: A total of 145 DCM patients were enrolled, based on left ventricular ejection fraction (LVEF), the patients were divided into 3 groups: Mild heart failure (HF) group, the patients with LVEF≤45%,n=15, Moderate HF group, LVEF≤40%,n=58 and Severe HF group, LVEF≤30%,n=72. LVEF, left atrial diameter (LAD), left ventricular end-diastolic diameter (LVEDD) and blood levels of BNP were examined and compared at prior and 7 days after levosimendan treatment respectively. Results: Compared with prior treatment, fater7 days of levosimendan medication, LVEF was elevated at certain degree in all 3 groups, while the statistic improvement was only found in Severe HF group (26.06±3.59) % vs (24.79±2.81) %,P<0.05; LAD and LVEDD had no obvious changes with levosimendan medication in all 3 groups,P>0.05. After levosimendan treatment, blood levels of BNP were decreased in all 3 groups as in Mild HF group (604.80±631.87) pg/ml vs (1252.17±1435.39) pg/ml, Moderate HF group (2369.78±2478.59) pg/ml vs (3206.90±2677.15) pg/ml and Severe HF group (4879.63±5302.42) pg/ml vs (6004.46±5041.59) pg/ml, allP<0.05. The differences of BNP level between prior and after levosimendan treatment, the ratio for BNP reduction were similar among 3 groups, allP>0.05. Conclusion: Levosimendan may, in short term, improve the cardiac function in DCM patients with mild, moderate and severe HF with similar degree; while it could not really change the cardiac structure.