After the origin, definition and functions of core journal were described, scientifically understanding their value and accurately defining their functions were proposed.The current evaluation of military sciences core journals was analyzed with measures put forward for perfecting their evaluation systems.

Recently,basic and clinical researches have shown that blood glucose variability is an independent risk factor for diabetic complications.Thus,ideal control of blood glucose is not only to reach the HbA1Ctarget,but also to minimize blood glucose variability.Different glycemic parameters could be selectedaccording to different purpose of evaluation,in which the mean amplitude of glucose excursions(MAGE) and the standard deviation of blood glucose (SDBG) could be used as accurate and simple assessment parameters respectively.

LDM, a product of the combination of contemporary information network technology and the tradi tional medical mode, is a rapidly developing new undertaking of recent years. The transformation of the medical mode in the establishment of LDM has brought about a series of problerms, including quality control of LDM, delegation of responsibility in IDM, standardization and unification of LDM, and psychological problems of patients under the mode of LDM. These problems present issues of new contemplation and exploration for hospital managers.

Objective To investigate the effect of seasonal variation of blood pressure (BP) on the incidence of cardiovascular and cerebrovascular events in the elderly aged 80 years and over.Methods The 67 patients (aged 80-86 years) with essential hypertension were enrolled, the BP were measured at home, in consulting room, and by 24-h ambulatory BP monitor in every season for 2 years. The incidences of cardiovascular and cerebrovascular events were recorded in the meantime.Results Both systolic BP (SBP) and diastolic BP (DBP) were lower in summer than in any other season (P＜0. 01 ). SBP was higher in winter than in any other season. (P＜0.01), DBP was higher in winter than in summer(P＜0. 01). There were no significant differences in SBP and DBP between spring and autumn. The incidence of cardiovascular and cerebrovascular events were higher in winter and summer than in spring and autumn (P＜0.05). The season (OR= 1. 525, P=0. 001), BMI (OR =1.145, P=0.018) and heart function (OR= 2. 037, P=0.01) were related to the incidence of cardiovascular events. And the season (OR = 1. 604, P= 0. 001 ), history of cerebrovascular disease (OR= 1. 598, P=0. 034), office-measured SBP (OR=0.960, P=0.013) and ambulatory DBP (OR =0. 936, P = 0. 008) were related to the incidence of cerebrovascular events.Conclusions The blood pressure measured by three methods in the elderly aged 80 and over shows that both SBP and DBP are at the lowest in summer; SBP is at the highest in winter, DBP is higher in winter than in summer. There are no significant differences in BP between spring and autumn. The incidences of cardiovascular and cerebrovascular events are significantly higher in winter and summer than in spring and autumn.

Objective To explore the clinical application value of whole-brain CTA-CTP imaging in cerebral arteriovenous malformation (cAVM).Methods Fifteen patients diagnosed with cAVM by CTA-CTP imaging were included in this retrospective analysis study. The angioarchitecture of cAVM lesions were recorded from 4D-CTA images.Using DSA as the golden standard,the diagnostic accuracy of 4D-CTA was evaluated in 13 cases.The perfusion patterns of vessel nidus and peritumoral tissues were analyzed from the CTP images.Bleeding ratios of patients with different angioarchitecture and perfusion patterns were compared.Results 4D-CTA could dynamically display the angioarchitecture details of cAVM lesions and show the whole process of the contrast agent in and out of the vessel nidus.Although the result of 4D-CTA was consistent with that of DSA in most cases,a few fine feeding arteries and draining veins were missed.The nidus in thirteen cases was with high perfusion and the peritumoral tissues were with low perfusion.Another two cases were with low perfusion due to the presence of hematoma.Nine cAVMs suffered from small size,single feeding artery,deep venous drainage and vessel nidus with increased MTT,peritumoral tissues with decreased MTT were more likely to suffer a hemorrhage (P<0.05).Conclusion Whole-brain CTA-CTP imaging could be a valuable adjunct in noninvasive diagnosis of cAVM and predicting the bleeding risk factors.

An innovative approach,named associating liver partition and portal vein ligation for staged hepatectomy (ALPPS),has made possible a marked increase in future liver remnant (FLR) over a short period of time,and has challenged the concept of unresectability.To date,ALPPS has been employed for a variety of primary and metastatic liver tumors from many centers across the world.Many technical variations of ALPPS have been described.However,much controversy has surrounded this procedure,and many problems remain to be solved,such as the reasons for rapid hypertrophy,the technical feasibility,safety and long-term oncologic outcomes,and the result compared with the conventional two-stage hepatectomy.These aspects are needed to be evaluated further in large-scale studies.We believe that the ALPPS procedure will has much room for further development.

Objective:To study the HBV infection in peripheral blood mononuclear cells in mediating the role of mother -to-child transmission of hepatitis B virus.Methods: The peripheral blood mononuclear cells ( PBMCs ) in maternal and cord blood mononuclear cells ( CBMCs ) in newborns were conventionally isolated by Ficoll-Hypaque medium.The loads of HBV-DNA in peripheral blood of maternal and cord blood of newborns were both detected by PCR .Results:The clinical data showed that the positive detection rates of HBV-DNA in serum and PBMCs of pregnant women with HBeAg (+) were 100.00%( 25/25 ) and 72.00%( 18/25),and the positive detection rates of HBV-DNA in the neonatal umbilical cord blood serum and CBMCs were 60.00%(15/25) and 44.00%(11/25),respectively.There were significantly difference between HBeAg (+) and HBeAg(-) in the pregnant women (P<0.05 ).The positive detection rates of HBV-DNA in neonatal umbilical cord blood serum and CBMCs were higher in the group with high HBV loads (more than 106copies/ml) in PBMCs than those of low HBV loading group (102-103copies/ml).The significantly difference was explored between the two groups.Conclusion: Mononuclear cells can not only be infected by HBV , but also play a critical role in the intrauterine vertical transmission of HBV via the pathway transmitted from PBMCs in pregnant women to CBMCs in newborns.

Objective To evaluate the risk factors of gallstone occurrence after gastrectomy for gastric cancer.Methods Relevant documents published from 1990 to 2014 were retrieved through Pubmed,Cochrane Library,Embase,Web of Science CNKI,Wan Fang and VIP databases search.The Meta-analysis was applied with RevMan 5.3 software for Odds ratio and 95％ CI.Results 24 studies were selected for this Meta-analysis which included 3 randomized controlled trials,13 cohort studies and 8 case-controlled studies.These 24 studies included patient number which ranged from 32 to 893.The pooled OR (95％ CI) and P values of OR (95 ％ CI) for physiologic digestive tract reconstruction were 0.53 (0.44 ～ 0.65,P ＜ 0.05) ;amount of resection of stomach,1.98 (1.29 ～ 3.04,P ＜ 0.05) ; lymphadenectomy,0.38 (0.21 ～ 0.72,P ＜ 0.05) ; vagotomy,0.24 (0.13 ～ 0.45,P ＜ 0.05) ; and pylorus preservation,0.70 (0.48 ～ 1.02,P ＞ 0.05).Conclusions Physiologic digestive tract reconstruction and vagus nerve preservation reduced occurrence of gallstones after gastrectomy.On the other hand,total gastrectomy and extensive lymph node dissection increased the occurrence.There was no significant difference in the occurrence of gallstones whether there was pylorus preservation or not.

Objective To explore the effect of oleanic acid on key enzyme activity in insulin-resistant HepG2 cells. Methods The HepG2 cells were divided into normal control,model control,metformin,and oleanic acid groups.Glycogen content in insulin-resistant HepG2 cell model were detected by hepatic glycogen test kit upon treatment with oleanic acid.Activities of glucokinase ( GK) ,phosphoenolpyruvate carboxylase kinase (PEPCK),and glucose-6-phosphatase (G-6-Pase) were assayed by the glucose 6-phosphate dehydrogenase coupling colorimetric, lactate dehydrogenase coupling colorimetric and ammonium molybdate constant phosphorus methods. Results The oleanic acid enhanced glucose consumption,lowered the activity of G-6-Pase and PEPCK by 54.8% and 18.8%,respectively,and increased the activity of GK and glycogen content in also insulin-resistant HepG2 cells by 100.6% and 98.6%,respectively. Conclusion Aqueous extracts of shirako play a role in lowering PEPCK and G-6-Pase activities and inhibiting glucogenesis, resulting in the reduction of endogenous glucose in the cell. In addition,it can augment the activity of GK,accelerate the process of glucolysis,increase the glycogen content,and alleviate insulin resistance of HepG2.

Objective To investigate the blood glucose control level,the characteristics of complications and treatment programme in senile patients with type 2 diabetes.Methods From Aug 2010 to Jul 2011,gender,age,height,weight,disease course and underlying disease were recorded in 119 patients with type 2 diabetes aged 80 years and over.The levels of glycosylated hemoglobin (HbA1c),fasting C-peptide (FC-P) and 2 hours postprandial C-peptide (2h C-P),urinary albumin excretion rate (UAER) were tested.Ultrasonic Doppler examination of lower-limb arteries as well as non-mydriatic colour eye-ground photography were also examined,peripheral nerve lesions were evaluatcd according to the criteria of diabetic neuropathy system (DNS).The patients were divided into two groups:HbA1c＜7.0％ group (65 cases) and HbA1c ≥ 7.0 ％ group(54 cases).Results The disease course[(12.1±8.5)years vs.(16.6±7.5)yeas,t=3.01,P=0.003],UAER[(20.2±11.9)μg/min vs.(47.0±21.4)μg/min,t=2.48,P=0.015] and incidence of diabetic nephropathy [23.1％(15/65)vs.50.0％(27/54),x2=9.36,P=0.002] were all less in HbA1c＜7.0％ group than in HbA1c ≥ 7.0％ group,while the levels of FC-P and 2hC P were higher in HbA1c＜7.0％than in HbA1c ≥ 7.0％ group[(2.1±1.2)μg/L vs.(1.5±1.0)μg/L,t=1.87,P=0.042; (6.5± 3.3)μg/L vs.(4.3 ± 2.9) μg /L,t =2.10,P =0.037].The proportion of patients who took oral hypoglycemic agents was increased while those who received insulin therapy decreased in HbA1c＜7.0％ group (all P=0.000).The α-glucosidase inhibitors were the most commonly used in each group,followed by metformin and insulin secretagogue,and the thiazolidinediones were rarely used,while there was no significant difference in the proportion of medicine between the groups.The overall incidence of symptomatic hypoglycemia was 23.5％(28/119).It was higher in HbA1c ≥ 7％ group than in HbA1c＜7.0％ group[33.3％(18/54)vs.15.4％(10/65),x2 =5.20,P=0.022].However,71.4％(5/7)of the patients with hypoglycemic coma came from HbA1c＜7.0％ group.Conclusions There are obvious individual differences in blood glucose control and complications among senile type 2 diabetes patients,thus the characteristics of the elderly should be considered in the choice of drugs while hypoglycemic events should be paid more attention.