[Summary] 2015 AACE/ACE Clinical Practice Guidelines for Integrated Management of Diabetes are updated and revised on the basis of 2011 edition. The guidelines highlight the comprehensive consideration of micro- and macro-vascular risks rather than merely focusing on the strategies and approaches of glycemic control. The guidelines also emphasize individualized targets for weight loss and the management of hyperglycemia ,dyslipidemia and hypertension and that more attention should be paid to safety of individualized treatment other than efficacy.

Objective To investigate the changes of TNF-?,IL-2 and IL-1? level in serum of patients with viral myocarditis and its clinical meaning.Methods The level of serum TNF-?,IL-2 and IL-1? in 45 cases of viral myocarditis was detected by ELISA,and the data were compared with control group.Results Serum TNF-?,IL-2 and IL-1? levels in viral myocarditis patients were significantly higher than control group and related to severity of the disease.Conclusion It suggests that immune dysfunction exists in patients with viral myocarditis.Higher level of TNF-?,IL-2 and IL-1? may be associated with development of the viral myocarditis,and it can be a new indicator for viral myocarditis.

Objective To investigate the effect of microRNA-101 (miRNA-101) on atrial fibrosis in human chronic atrial fibrillation (AF). Methods Right atrial appendages were obtained from 59 patients (30 with AF) undergoing cardiac surgery, including 47 patients with valve heart disease and 12 patients with congenital heart disease. The expression of miRNA-101 was determined by quantitative real-time PCR in the right atrial appendages of patients with and without AF. The cell-specific localization of miRNA-101 was detected by in situ hybridization assay. The mRNA and protein expression levels of transforming growth factor β typeⅠreceptor (TGFβRⅠ) and collagen type I (COL1) were determined by quantitative real-time PCR and Western-blot assay, respectively. Collagen in the right atrial appendages was observed by Masson staining assay. Results The expression of miRNA-101 was found to be significantly down-regulated in AF patients compared with patients with sinus rhythm (SR) (P < 0.05). The result of miRNA-ISH showed that miRNA-101, which was highly distributed within the connective tissues of heart, was down-regulated at about 24.9% in patients with AF compared with patients with SR. No significant differences at the mRNA expression level of TGFβRI was found between patients with AF and patients with SR (P > 0.05). But the protein expression of TGFβRI in patients with AF was significantly higher than that of patients with SR (P < 0.05). The mRNA and protein expressionsl of COL1 were significantly higher in patients with AF than thoset of patients with SR (P < 0.05). The collagen was significantly increased in patients with AF than that of patients with SR (P < 0.05). Conclusions Downregulation of miRNA-101 may contribute to atrial fibrosis in human atrial fibrillation by targeting TGFβRⅠ.

OBJECTIVE To investigate the drug-resistance of AmpC enzyme derepressing Enterobacter cloacae isolated from patients of respiratory department.METHODS Totally 364 strains of E.cloacae(162 strains from respiration department) collected from Jan 2001 to Dec 2006 were investigated to know their ward distribution,infection site and susceptibility test results.Three-dimensional tests were adopted to test AmpC lactamase.RESULTS Among the total 162 strains from respiration department,AmpC producers were 76 strains,accounting for 46.91%. Among the 202 strains from the other departments,however,AmpC producers were 36 strains,accounting for 17.82%.And drug-resistance of E.cloacae from respiration department was distinctly higher than that from the other departments.CONCLUSIONS E.cloacae from respiratory department has the higher isolating rate and drug-resistance rate.We should take effective measurement to contain nosocomial infections with E.cloacae.

OBJECTIVE To investigate the resistance phenotype and clinical feature of super extended spectrum ?-lactamases(SSBLs) producing Escherichia coli in order to provide reference for the clinical application of drugs.METHODS Totally 945 strains of ESBLs producing E.coli collected from Jan 2003 to Jun 2007 were identified by API microbiological assay system.Susceptbility tests were performed by K-B methods.Improved three-dimensional tests were adopted to test ESBLs and AmpC lactamase.Test data were analyzed statistically by WHONET 5.3 software.RESULTS From them eighteren strains of SSBLs producers were detected.Between the positive for ESBLs strains and the negative strains,there were some significant differences in the antimicrobial resistance(P

BACKGROUND: Monosialotetrahexosylganglioside plays an important role in a variety of physiological processes, such as the nerve cel growth and development, differentiation, regeneration and intracel ular and extracel ular information transmission. OBJECTIVE: To investigate the effects of monosialotetrahexosylganglioside on the changes of gene expression and calcium ion concentration in the course of inducing the mesenchymal stem cells into neuron-like cells with Woodbury’s method. METHODS: The mesenchymal stem cells from Sprague Dawley rats were cultured after isolated and purified, After 5 passages in culture, the cel integrated into a dense monolayer, and treated with 50 mmol/L monosialotetrahexosylganglioside for 24 hours as the monosialotetrahexosylganglioside group; then the mesenchymal stem cells were induced into neuron-like cells with the methods of Woodbury after pre-cultured for 24 hours, and set the control group. The protein and mRNA expression levels of growth-associated protein 43, neuron-specific enolase, neurofilament and nestin were detected by immunocytochemistry and real-time PCR, respectively. The fluorescence intensity of intracel ular free calcium ion before and after inducing was detected by laser scan confocal microscope. RESULTS AND CONCLUSION: After induction, the expression levels of growth-associated protein 43, neuron-specific enolase, neurofilament and nestin of the mesenchymal stem cells in the monosialotetrahexosylganglioside group were higher than those in the control group (P < 0.05), demonstrating that monosialotetrahexosylganglioside could promote the differentiation of mesenchymal stem cells into neuron-like cells. The fluorescence intensity in mesenchymal stem cells was increased gradual y in two groups after the medium was replaced by the induction medium, attained its peak value at 100 seconds and then decreased gradual y, but the fluorescence intensity was stil higher than that before the induction at 20 minutes. The fluorescence intensity of intracel ular free Ca2+ was increased significantly in the monosialotetrahexosylganglioside group when compared with the control group (P < 0.05), suggesting that monosialotetrahexosylganglioside could increase the concentration of intracel ular free Ca2+, and intracel ular free Ca2+ may be useful in the course of induction. The changes of protein expression levels of growth-associated protein 43, neuron-specific enolase, neurofilament and nestin were not significant after induction, indicating that Woodbury classic induced programme could regulate the post-transcriptive protein level.

Objective To observe the effect of RNAi that silences MTA1 gene on invasion and migration of esophageal carcinoma 9706 cells. Methods The siRNA expression vector that silences MTA1 gene was transfected into EC9706 cells by liposome. MTA1 mRNA and protein expressions were detected through quantitative RT-PCR and Western blot, respectively. The invasion and migration of EC9706 cells were evaluated by scrape wound healing assay and cell invasion assay in vitro. Results MTA1 gene expression significantly decreased. The scrape wound of EC9706 cells healed more slowly and the cell population that cut through Matrigel were less in the EC9706 cells transfected with siRNA expression vector than non-transfected EC9706 cells and the EC9706 cells transfected with blank vector (P

Objective:To explore the effect of endothelin-1 on atrial ifbrosis in patients with atrial ifbrillation (AF).
Methods: A total of 72 patients with thoracotomy were studied, the patients were divided into 2 groups:AF group, n=39 and Sinus rhythm (SR) group, n=33. The mRNA and protein expressions of endothelin-1 (ET-1), platelet derived growth factor-B (PDGF-B) and collagen I (COL1) in right atrial appendage (RAA) tissue were measured by RT-PCR and Western blot analysis;meanwhile, the impact of ET-1 stimulation and non-selective ET-1 receptor antagonist (sulfafurazole SIZ) on PDGF-B mRNA and protein expressions in H9c2 cells were measured.
Results: ①The RAA tissue mRNA and protein expressions in AF group were higher than those in SR group, as for ET-1 (2.830 ± 2.276) vs (1.220 ± 0.887) and (0.835 ± 0.241) vs (0.286 ± 0.083), both P<0.01;for PDGF-B (2.568 ± 2.348) vs (1.567 ± 0.831) and (0.807±0.241) vs (0.381 ± 0.105), both P<0.05;for COL1α1 (3.376 ± 1.598) vs (1.629 ± 0.833) and (0.652 ± 0.210) vs (0.312 ± 0.12), both P<0.05.②The protein expressions of ET-1 and COL1 had positive correlation (r=0.580, P<0.01).③ET-1 promoted PDGF-B secretion in H9c2 cells in a concentration and time-dependent manner;SIZ could reduce such promotion.
Conclusion: ET-1 plays an important role in AF occurrence which might be related to PDGF-B regulation.

BACKGROUND: Apolipoprotein(a) [Apo(a)] plays some role in promoting the formation of atherosclerotic plaque, and contains pentanucleotide repeats(PNR), which has a key value in genic research and in forecast on the increased risk of early atherosclerosis cerebral infarction (ACI). But the relationship between ACI and Apo(a) PNR in different races needs to be further investigated.OBJECTIVE: To investigate the relationship between the Apo(a) PNR polymorphism and ACI.DESIGN: A case-control study based on the ACI patients and normal people of Han nationality in Hubei.SETTING: Department of Laboratory in a hospital of a university.PARTICIPANTS: From February 1998 to March 1999, 82 ACI patients (ACI group) and 153 healthy controls(control group) were selected from the Department of Neurology, Central South Hospital and Yatai Hospital of Wuhan University. All patients were Han nationality in Hubei without any relatives.METHODS: Serum lipoprotein(a) [Lp(a) ], total cholesterol(TC), high density lipoprotein cholesterol(HDL-c), low density lipoprotein cholesterol (LDL-c), triglyceride (TG), apolipoprotein A Ⅰ (ApoA Ⅰ) and apolipoprotein B (Apo B) were tested respectively. Meanwhile, the PNR in the 5' control region of the Apo(a) was detected with polymerase chain reaction(PCR) and high voltage polyacrylamide gels electrophoresis. The results were analyzed with controlled analysis.RESULTS: The levels of serum Lp(a) [ (239.9 ±225.4) mg/L], TC [(4.76±0.74) nmol/L], TG[(1.74±0.60) mmol/L] and LDL-C [ (2.84 ± 0. 63) mmol/L] were remarkably higher in ACI group than those in control group, which were(133.5 ±97.7) mg/L in serum Lp(a), (4. 29±0.72) mmol/L in TC, (1.05±0.52) mmol/L in TG and(2.84±0.63) mmol/L in LDL-C, however, the level of HDL-C[ (0.88± 0.17) mmol/L] was remarkably lower in ACI group than that in control group [ ( 1.03 ± 0. 35 ) mmol/L], the differences were all significant( t = 3.65to9.18, P ＜ 0.01) . The levels of ApoA Ⅰ [(1.13±0.15) mmol/L,(1.25±0.19) mmol/L] and ApoB[(0.93±0.12) mmol/L, (0.89± 0. 15 ) mmol/L] were no significant difference compared with those in control group. The duplicated frequency of the allele(TTTTA) 5(0. 098) in the ACI was remarkably higher than that in control(0. 026) (x2 = 5.62, P＜ 0. 05), The frequency of the allele(TTTTA) 9 in the ACI(0. 073) was remarkably lower than that in control (0. 213 ) (x2 = 7.83, P ＜ 0.01 ), The frequency of the allele(TTTTA) 5 was also associated with low TC and high Lp(a) levels.CONCLUSION: It is suggested that the Apo(a) PNR polymorphism are associated with the susceptibility to ACI, and involved in the development of ACI.

Objective To evaluate the diagnostic and prognostic value of BRAF V600E mutation screening of ultrasound-guided fine-needle aspiration (FNA)specimens in patients with thyroid nodule. Methods The BRAF V600E mutation status were assessed in FNA specimens of 104 patients with thyroid nodules before operations.The BRAF mutation status,clinical,and pathology records of the patients were reviewed and the associations between these characteristics and papillary thyroid cancer (PTC ) were analyzed.Results Seventy-one PTC and 14 benign thyroid nodules were included in this study.BRAF V600E mutations were found in 57/71 (80%)PTC.All benign thyroid nodules had no BRAF V600E mutation.The sensitivity,specificity,positive predictive value and negative predictive value of BRAF V600E mutations in differentiation between PTC and benign thyroid nodules were 80%,100%,100% and 50%(P < 0.001 ).In 44 patients with PTC who underwent surgery,the central compartment lymph node metastases and extrathyroidal invasion were not significantly different between BRAF-positive and BRAF-negative PTC (P = 0.283 and 0.307 ).Conclusions BRAF V600E mutation may be a potential tool to facilitate ultrasound in diagnosis of PTC.In patients with PTC,the presence of the BRAFV600E mutation was not significantly associated with prognostic factors.