Objective To discuss the clinical effect and safety on rosiglitazone applied to patients with early type 2 diabetic nephropathy.Methods Ninety-six patients with early type 2 diabetic nephropathy were divided into the control group(n=48) and the research group (n =48).The patients of the control group were given mefformin treatment, while of research group were given rosiglitazone, both the courses were three months.The urinary albumin excretion rate (UAER), 24 h urine trace albumin (UAE), serum creatinine clearance (SCr) , fasting plasma glucose (FPG), postprandial blood glucose (2 hPG), glycosylated hemoglobin (HbA 1 c), triglycerides (TG), cholesterol (TC), low density lipoprotein (LDL-C), high density lipoprotein (HDL-C) before and after treatment and clinical effect between the two groups were compared.Results The HbA1c, FPG, 2 hPG, UAER, UAE, TC, TG of after treatment of all patients decreased obviously,while the HDL-C level increased remarkably, and compared with control group the differences were significant (HbA1 c: (7.32±0.84)％ vs (7.56±0.98)％, FPG: (8.02± 1.42) mmol/L vs (8.16± 1.54) mmol/L, 2 hPG: (11.54±2.11) mmol/L vs (12.02±1.97) mmol/L,UAER: (67.34±6.45) mg/24 h vs (52.56±5.35) mg/24 h,UAE: (108.64±22.64) mg/d vs (68.84± 11.43) mg/d, TC : (5.44± 0.72) mmol/L vs (4.76± 0.51) mmol/L, TG: (2.04± 0.53) mmol/L) vs (1.73±0.46) mmol/L);t =-4.172,-3.973,-4.026,-4.263,-6.634,-5.737,-5.635, -4.735,-4.633;P＜O.05).While there were no statistical significance about SCr before and after treatment(P ＞0.05).The total clinical effect of the research group was obviously higher than that of the control group (87.5％ (42/48) vs 66.7％ (32/48), x2 =5.363,P =0.035).There were not obvious adverse reaction occurred during treatment for all patients.Conclusion Rosiglitazone can effectively reduce the blood glucose in patients with early type 2 diabetic nephropathy and reduce urinary protein excretion, the effect is more obvious than that of metformin.

he blood supply of corpus callosum is rich, its function is complex, and the incidence of infarction is low. The risk factors and etiology for callosal infarction do not have any difference with the infarction in other parts of the brain. The clinical manifestations of the disease are complex and diverse. The two classical clinical manifestations are callosal disconnection syndrome and frontal-type gait disorder, but hemiplegia, monoplegia, apraxia, and mental retardation are common in clinical practice. The positive rate of CT scan is lower. MRI has higher sensitivity and specificity for callosal infarction. The diagnosis of callosal infarction is not difficult according to the history and imaging examination, however, it needs to be differentiated with other diseases that likely involve corpus callosum. Most of the patients with callosal infarction have good prognosis.

Objective To investigate the clinical features,safety and clinical efficacy of the posterior decompression and interbody fusion with internal fixation for complete thoracolumbar fracture and dislocation.Methods The clinical data of 23 patients with complete thoracolumbar fracture and dislocation treated by posterior decompression and interbody fusion with pedicle screw fixation from August 2011 to October 2014 were retrospectively analyzed.There were 18 males and 15 females,aging from 20 to 50 years old with an average age of 38.2±0.3 years.There were 8 cases of T10,11 vertebral dislocation,8 of T11,12 vertebral dislocation,3 of T12L1 vertebral dislocation,and 4 of L1.2 vertebral dislocation.All the patients had different degrees of multiple rib fractures and pneumothorax complications.Preoperative spinal cord nerve function was evaluated according to the American Spinal Injury Association of spinal cord function (ASIA).There were 10 cases of ASIA grade A and 13 cases of grade B.Operation time,intraoperative blood loss,clinical outcome,imaging X-ray and CT examination,segmental kyphosis angle and bone graft fusion were recorded.Results All the patients were followed up for 13 to 26 months,average 20.2±4.3 months.The operation time ranged from 150 to 260 min with the average time of 180.3± 14.8 min;intraoperative blood loss was 800-1 500 ml with the average of 950.2±98.1 ml.Preoperative sagittal Cobb angle was-13.5° ±6.3° (range,-20.1° to 2.3°);postoperative sagittal Cobb angle was 1.43°±6.4° (range,-7.6° to 3.5°);at the latest follow-up,sagittal Cobb angle was 1.6°±6.3° (range,-8.1° to 10.3°);the dislocation reduced from preoperative 100％ to postoperative 0-15％ (10％±6％).After operation,the ASIA grade of 2 cases improved from A to B,and 5 cases improved from B to C.All of the patients had bone fusion after operation,no false joint or nonunion occurred,no loosening or breakage of internal fixation occurred.Conclusion There are high risks and difficulty of surgery for those who with thoracolumbar fracture dislocation and severe injuries of spine and spinal cord combined with multiple injuries.Proper treatment of preoperative complications is the premise of good curative effect;reliable fusion and long segment internal fixation is the key of operation.Single posterior decompression and reduction with interbody fusion and internal fixation is less invasive and could achieve satisfactory clinical efficacy.

Preliminary exploration on subject librarian mechanism and service is carried out in college and university libraries in Chi-na. The paper introduces actual needs, implementation modes, service contents and forms of subject librarian service in Library of China Medical University;hopefully the good experience would provide reference to other medical colleges and universities.

Objective To analyze the ability of pretend play and the development level of Theory of Mind (ToM) in moderately intellectual disability (ID) children, and the relationship between them. Methods 30 children aged 10~15 years were observed with experiment and behavior observation. Results The development levels of ToM and pretend play were different with their age (P<0.05). ToM score significantly correlated with the ability of role assignment, imagination and role playing after controlling the age (P<0.05). Conclusion The ability of pretend play develops unbalancedly in the moderately ID children, and the development level of ToM correlates with some categories of pretend play

Objetive To explore the feature and influence of psychological trauma of severe physical violence (SPV) perpetrators with or without violent pedigree,and to provide theoretical basis in the intervention of domestic violence.Methods The cases of domestic violence were identified based on appeals for help to police stations,local Women' s Federations,Residents' Community Committee,Center of Community Health Services,the judicial branch of city governments.The subjects were screened,recruited and divided into the group of the abusers with violent pedigree(AP,n=136),the group of abusers without violent pedigree (ANP,n =105),the group of non-abusers with violent pedigree(NAP,n=105) and the group of non-abusers without violent pedigree(NANP,n =198).The features and influence of psychological trauma in four groups were compared.Results (1) In AP group,above 6 traumatic events got 66.1 percent.The median of the number of traumatic events in AP group was 7,and outstanding statistical significance existed among four groups(P＜0.01).(2)The scores of avoidance (1.37± 0.79) and intrusion(1.40±0.80) and added scores of IES-R(4.08±2.30) in AP group were significantly higher than the other groups,while the scores of hyper-vigilance (1.31 ± 0.88) were higher than NAP (0.95 ± 0.75) and NANP group(0.94±0.83).The scores of intrusion(1.22±0.83) and hyper-vigilance (1.14±0.85) in ANP group were significantly higher than those in the NANP group(P＜0.05).(3)The scores of witness DV,childhood emotional,physical and sexual abuse and the numbers of traumatic events were positively related with the traumatic symptoms.Conclusion The traumatic experiences are significantly correlated with severe physical violence behavior among violence perpetrator with violent pedigree.Some traumatic experiences may be the protective factors of domestic violence behavior.In the violent pedigrees,abusers have the most severe traumatic symptoms and their traumatic symptoms,especially intrusion and hyperarousal symptoms,are positively correlated with severe physical violence behavior.

Objective:To study the masseter motor evoked potential(MEP)in patients with sleep bruxism(SB)and in healthy con-trols.Methods:30 subjects with SB and 30 healthy controls were included.MEPs were obtained by transcranial magnetic stimulation (TMS).Tests were done during daytime when the subjects were awake.The data were statistically analysed.Results:In the patients AMT was 55(52,55)%,latency of c-MEP (6.7 ±1.3)ms,the amplitude of c-MEP 0.19(0.15,0.29)mV,latency of r-MEP (2.3 ±0.4)ms,the central conduction time(CCT)4.4(3.3,5.2)ms.In the control subjects AMT was 52(52,55)%,latency of c-MEP (6.4 ±0.7)ms,the amplitude of c-MEP 0.23(0.17,0.28)mV,latency of r-MEP (2.4 ±0.4)ms,CCT 4.0 (3.4,4.4) ms.No significant difference was found between the 2 groups in the measurements evoked by TMS.Conclusion:The MEP after TMS in patients with SB is similar to that of healthy subjects,indicating that the excitability of the cortical motor system is not changed in bruxism subjects,at least when evaluated by TMS.

Objective To review and summarize the effects of interventional treatment of hand arteriovenous malformation in 5 cases.Methods Through catheterization of brachial artery ipsilaterally the blood-supply artery of arteriovenous malformation was embolized,using high-temperaure managed gelatin sponge,silk thread,pingyangmycine and spring coil.Results Total 13 blood-supply arteries in 5 cases were embolized with successful rate of 100%,including 1 case of complex malformation under effectively controlled,3 cases cured clinically and 1 case still awaiting observation.Conclusions Transcatheter arterial embolization for the treatment of hand arteriovenous malformation is safe,effective and high successful.(J Intervent Radiol,2007,16:277-279)

Objective To discuss the clinical manifestations and imaging diagnostic value of tuberous sclerosis accompanied by multi-organ injuries.Methods 2 cases in our hospital and 27 cases of tuberous sclerosis from the published reports were collected.The clinical manifestations and imaging features as well as the extent and type of multi-organ lesion were analyzed.Results Among the 29 patients,17 were male and 12 were female.The averaged age was 16.8.The clinical manifestations included:with family history in 6 , epilepsies in 25 (15 with mental retardation),symmetric angiofibroma in the face in 22 (3 with similar changes in the else body surface),fibromas beneath toenail or fingernail in 4, hyperdactylia of thumb in 2 and abdominal masses in 7 (4 with hematuria), tuberous scleroses beneath ependymal layer in 27,17 patients with kidney diseases,9 involved liver,5 involved spleen.Conclusion Multiple organs can be involved by tuberous sclerosis.The calcification of ependymal lyer and harmatoma of kidney are the most valuable in imaging diagnosis of the disease.

Objective: To study if the immune-enhancing effect of Arg was mediated via liver.Methods: The direct effect of Arg on T cell proliferation was measured by 3H-TdR incorporation. Rat hepatocytes were primarily cultured in serum-free DMEM/F12 medium, and then cultured in medium containing Arg(?mol/L:0,7.5,75,750,7 500), and the supernatant was collected at 0, 24, 48, 72 hours, and added to splenocytes culture, and T cell proliferation, NK cell activity and IL-2 activity,〔Ca 2+〕i were measured respectively.Results: Arg had no direct effect on splenocyte proliferation. The hepatocyte culture supernatant significantly increased the lymphocyte〔Ca 2+〕i ,IL-2 activity and T lymphocyte proliferation; 7 500 ?mol/L was most effective. Conclusion: Arg may enhance immune function via secretion of bioactive molecules by hepatocytes.