Diabetes results in excess cardiovascular mortality.Unexpectedly,more strict glucose control induced more death in a large scale clinical trial and the increased hypoglycemia was a suspected offender.In order to decrease the risk of hypoglycemia,three steps should be taken into consideration in future treatment of hyperglycemia in diabetic patients with cardiovascular disease: ( 1 ) Identifying hypoglycemia early even in its paradoxical feature.( 2 )Achieving glucose targets with personality.( 3 ) Designing the strategy of lowering plasma glucose more carefully,to pay special attention avoiding hypoglycemia.

The article discuss the design positioning and paper publication in clinical research. Taking the research articles published in this issue as examples, the author points out 4 rules that a scientific article must obey. These rules consist of creativeness, close connection with clinical science, relationship with important concepts and clinical practice, and reasonable statistical analysis of the data.

In newly-diagnosed type 2 diabetic patients,the first-phase insulin secretion is defective but reversible.Rebuilding of the first-phase insulin secretion seems to be another important target following the glycemic control and complication prevention.

We can not do any clinical research if knowing nothing of statistics. In order to understand the results from a clinical research, readers must know the characteristics of the data, the features of the selected variables, the relation between % and 95% confidence interval, as well as the definitions of difference in clinical and statistical analysis, and it may be more important to make the evaluation of mechanism based on suitable explanation of clinical significance by means of statistical results.

Type 2 diabetes mellitus is a chronic progressing disease.In some recent studies,hyper glycemic patients get fine control of blood glucose without any hypoglycemic agents after a period of treatment.These results suggest the possibility of remission of islet β-cell function,at least in some diabetic patients.Restoration of β-cell function brings a new hope in the treatment for type 2 diabetes mellitus.

Insulin secretion varies in a com pl icated manner including quantity released and timing, which is also regulated by both glucose load and insulin sensitivity. It makes the evaluation of ?-cell function difficult in scientific research as well as clinical practice. There is no any index that could reflect the function of insulin secretion perfectly so far. Therefore, it is necessary to have a clear understanding of the advantages and the disadvantages of the current available indices before to use them approp riately.

Objective To observe the expression of GFAP and CD34, the reaction of astrocytes and the correlation with microvessels in the surrounding areas after cerebral infarction in human was researched. Methods HE and immunohistochemistry were used to observe the changes of glial fibrillary acidic protein (GFAP)and CD34 in the surrounding areas after cerebral infarction in human. Results The expressions of GFAP and CD34 increased in 8h(P

0.05) in both groups. The results showed that the criteria of diagnosis by WHO arc rational.

It has become a prominent clinical problem that diabetes was induced by early long-term use of large-dose glucocorticoid for treating severe acute respiratory syndrome (SARS), which suggesting that indication and contraindication of glucocorticoid therapy should be followed strictly. Principles of treating the secondary diabetes induced by glucocorticoid are similar to that used in type 2 diabetes, however, the feature of severe afternoon hyperglycemia combined with fasting hypoglycemia should be taken into account in the protocol design.

Hyperinsulinemic euglycemic clamp technique can be used to evaluate insulin sensitivity in vivo. However, it is not fit for assessing the insulin sensitivity in large scale epidemiological studies in which some simple index is needed. In this paper we present some additional data to describe characteristics of the insulin action index(IAI)=1/(FPG×FIns). The Pima Indians recruited in this study,from which we suggested the IAI, had a very wide range of fasting plasma levels of glucose (75~306 mg/dl or 4.2~17.1 mmol/L)and insulin (9.7~120 mU/L)concentrations, The insulin-mediated glucose disposal rate (M value) assessed by the clamp technique were closely correlated to a various complex parameters involved to fasting glucose and insulin levels.The correlation coefficient of M value and IAI was significant (r>0.7, P=0.0001) and it was greater than that between M and fasting plasma insulin or the ratio of glucose to insulin and not inferior to the correlation between M and the products of areas of glucose and insulin during OGTT. The quintile distribution of the products of plasma glucose and insulin demonstrated that 90.4% IAI value were within the predicted M vatue quintile or its adjacent quintiles. The reverse of the product of fasting plasma glucose and insulin, 1/(FPG×FIns),closely correlates to human insulin sensitivity, thus it can be taken as an index of insulin sensitivity in epidemiological studies.