Cardiovascular disease (CVD) is one of the major complications of type 2 diabetes mellitus (T2DM), which results in a high risk of mortality. Thus, the cardiovascular safety of new anti-diabetic agents has become an important prob?lem with wide concern. There are two classes of incretine-based medications: glucagon-like peptide-1 receptor agonist (GLP-1RA) and dipeptidyl peptidase-4 (DPP-4) inhibitor (DPP-4I). It has been demonstrated that GLP-1RA and DPP-4I possesse beneficial actions in both animal models of cardiovascular dysfunction and patients with ischemic heart diseases. However, their effects on the cardiovascular system in diabetic patients with heart diseases are still uncertain. Here, we sys?tematically reviewed the effects of GLP-1RA and DPP-4I on cardiovascular system to provide more evidence of incretin-based therapy application for diabetes and complications.

BACKGROUND: The neurological basis for learning and memory is the high plasticity of central nervous system, and special rehabilitative training is necessary in the process of the functional recombination of central nervous system.OBJECTIVE: To observe the capability of rehabilitative training in differentiating learning ability and memory maintaining of one-trial passive avoidance response, and its correlation with the kinetic properties of Nmethyl-D-aspartic acid (NMDA) receptor channel of contralateral hippocampal neuron in rats with cerebral infarction.DESIGN: A randomized control animal trial.SETTING: Department of Rehabilitative Medicine, Affiliated Hospital of Luzhou Medical College.MATERIALS: The experiment was carried out in the central laboratory of Luzhou Medical College between March 2000 and February 2002. Twentyfour male Wistar rats were randomly divided into three groups with 8 rats in each: free movement after cerebral infarction group (model group), rehabilitative training after cerebral infarction group (rehabilitation group) and normal group.METHODS: ① Model establishment: Rats in the model group and rehabilitation group were made into models of infarction of right middle cerebral artery, and those in the normal group were not given any treatment. ②Rehabilitative training: After 4 days, only the rats in the rehabilitation group were trained with rolling-cage exerciser, screen exerciser and balance exerciser for 4 weeks. ③ Learning and memory tests: The learning and memory performances of all the rats were tested at 35 days postoperatively. The Y-maze test was applied to mainly observe the needed number f training for the rats to reach 9/10 correct response (for running to dark arm), and the multi-functional conditioned reflex box to observe the stayed duration on the diving board (step-through latency). ④ The single channel current property of NMDA receptor in hippocampal neurons was recorded with cell adhesion after learning and memory tests.MAIN OUTCOME MEASURES: ① training times needed for the rats to grasp the structure of the maze in each group; ② step-through latency in each group; ③ single channel current property of NMDA receptor in each group.RESULTS: All the 24 rats were involved in the analysis of results. ① The training times needed for the rats to grasp the structure of the maze in the rehabilitation group and normal group were significantly different from that in the model group [(68.02±11.67), (57.62±10.31), (107.07±16.32) times, P ＜0.05], and there was no significant difference between the rehabilitation group and normal group (P＞0.05). ② The medians of step-through latency before shock in the rehabilitation group and normal group were significantly different from that in the model group (286.7 s, 298.4 s, 126.7 s, P ＞0.05), and there was no significant difference between the rehabilitation group and normal group (P＞0.05). ③ The 35 pS short open NMDA receptor channel mainly existed in the hippocampal neurons of rats in the rehabilitation group, the open proportion was 0.099±0.007. The duration and proportion of 20 pS short and long open and the 35 pS short open NMDA receptor channels in the hippocampal neurons of rats were not significantly different from those in the normal group (P＞0.05). In the model group, 20 pS open channel was mainly observed, and the durations of 20 pS short and long open channels were obviously shorter than those in the rehabilitation group, the open proportion of 35 pS short open channel was 0.036t0.04, which was lower than that in the rehabilitation group,but no 35 pS long open channel was observed.CONCLUSION: Rehabilitative training accelerates the recovery of the learning and memory abilities of rats with cerebral infarction by changing the NMDA receptor channel properties of contralateral hippocampal neurons.

As a new biomarker and a member of transforming growth factor super family,growth differentiation factor-15 (GDF-15) is increased in some pathological situations,and plays a positive role.Increasing evidence from animals and clinical trials has indicated that GDF-15 is a promising biomarker to be used for diagnosis,screening,risk stratification and prognosis evaluation in acute coronary syndrome,heart failure and pulmonary vascular diseases.However,there are still numerous challenges and problems need to be resolved in the future,such as appropriate cut-off value in diagnosis and risk stratification in different cardiovascular diseases,improvement in sensitivity and specificity,and combinational application with other biomarkers.

Surgical treatment is the treatment of choice for gastrointestinal stromal tumor (GIST).A consensus on the surgical principle of GIST has been made based on the 10-year experience,which effectively guided the standardized treatment of GIST.Laparoscopic and gastrointestinal endoscopic techniques were applied in the treatment of GIST,and promote the development of the diagnosis and treatment of GIST.Laparoscopic treatment has become one of the main treatment methods for GIST.Furthermore,multi-disciplinary treatment for GIST is gradually adopted in clinical practice.In this article,the prospect of surgical treatment of GIST is introduced based on a 10-year experience.

BACKGROUND:Soft tissue releasing is a major means of correcting knee flexion contracture, and the soft tissue releasing methods are different for different knee joint diseases and degrees of deformity. Ideal soft tissue balance can gain a clear functional recovery and deformity correction from severe knee flexion contracture after total knee arthroplasty.
OBJECTIVE:To study the proper handling of knee flexion contracture and soft tissue releasing in total knee arthroplasty.
METHODS:Twenty-six cases of knee deformity in 20 ° to 60 ° receiving primary total knee arthroplasty were retrospectively studies. Steps of soft tissue releasing and residue deformity after each step were recorded. Postoperative fol ow-up was 12 months on average.
RESULTS AND CONCLUSION:The 26 cases were recovered from knee flexion deformity after soft tissue release. Posterior capsular release was carried out in al cases to different extents, and the flexion deformity and postoperative range were corrected and greatly improved, respectively. These indicate that the posterior capsular release and lateral col ateral ligament release can correct most of the flexion deformity, but increasing the distal femoral osteotomy is not necessary.

Objective　To obtain staphylococcal enterotoxin B (SEB) mutant with normal antigenicity but low toxicity. Methods　Using PCR technique, normal SEB (SEB-N) gene which was amplified from S. aureus S6B. SEB mutant gene (SEB-M) was prepared from the same strain, but one nucleotide in SEB gene was changed from asparagine (N23) to serine (S23). SEB-N and SEB-M were cloned into procaryotic expression vector pTrc99A then and transferred into E. coli JM109. SEB-N and SEB-M which were cloned into plasmid were sequenced directly by dideoxynucleotide method. The crude expressed proteins were identified by double agar immunodiffusion. The level of IL-2 in supernatants of mouse splenocytes stimulated by crude expressed proteins was determined by ELISA. Results　SEB-N and SEB-M were obtained through PCR. The sequence of SEB-N was changed with non site-directed mutagenesis, threonine at the residue 150 of SEB-N was replaced with alanine (ACT→GCT, T150A). As being expected, at the residue 23 of SEB-M, serine substituted for asparagine (AAT→AGT, N23S) with site-directed mutagenesis. Double agar immunodiffusion showed obvious precipitin line with anti-SEB by both crude SEB-N and SEB-M mutant proteins could produce, but not by non-recombinant strain. ELISA demonstrated that the level of IL-2 in supernatant of mouse splenocytes stimulated by natural SEB protein (containing equal amount of JM109P crude protein) was 40 times as much as that stimulated by SEB-M and 12.5 times as much as that stimulated by SEB-N. Conclusions　We obtained two recombinant strains which produced T150A and N23S mutant SEB protein. The mutant proteins showed binding ability to anti-SEB as the normal protein. However, their biological activity as superantigen decreased sharply. We consider that it is promising for further study of molecular adjuvant or superantigen vaccine.

[Objective]To explore the professor Yu Tugen’s experience, in order to provide reference for clinical medication and the study of atopic der-matitis. [Methods] Treatment based on syndrome differentiation. First, through the analysis of etiology and pathogenesis and clinical manifestations of atopic dermatitis, it is divided into types, respectively analyze each type, discuss the experience in the treatment of various types; then give examples of the treat-ment experience of dampness heat syndromes, analysis of diagnosis and treatment system.[Result]Atopic dermatitis is divided into the types of damp-heat accumulation, spleen deficient aggregates the skin wet, wind formation from blood deficiency. After dialectical treatment, symptom is relieved.[Conclusion] This topic comprehensively summarizes the famous expert Yu Tugen ’s academic thought and clinical experience of atopic dermatitis of the types of damp-heat accumulation, provides a more complete treatment concept based on syndrome differentiation of TCM of atopic dermatitis, to relieve pain and improve the quality of life.

Objective To assess the safety of living environment by the elderly, further clarify the relevant factors of the elderly fall in the living environment. Methods The self- made assessment form of fall-related factors of living environment for elderly patients was used to survey 1 076 elderly. Likert five grades score was used for each item, and the higher score demonstrated the safer living environment. Results In the assessment of the safety of living environment, the indoor physical environment (3.94 points), home furniture safety (3.66 points) score was better;home ground and the channel (3.32 points) and outdoor activities places (3.57 points) score was lower. Scores of home′s ground and channel, furniture safety, indoor physical environment and living environment of urban elderly were (23.56 ± 6.49), (44.52 ± 7.72), (11.93 ± 2.49), (105.03 ± 17.82) points, which were better than (22.46 ± 6.39), (42.73 ± 7.95), (11.53 ± 2.39), (101.55 ± 18.15) points of rural elderly (t=2.471-3.495, P <0.05). Conclusions The indoor physical environment, home furniture safety got higher scores, and the scores of ground-channel environment and outdoor activities places were relatively lower. Scores of the safety of living environment in urban are better than in rural. It suggests the elderly living environment need to reduce the incidence of falls.

OBJECTIVE: How to promote the generation of neural stem cells (NSCs) and induce them differentiate into the goal cell type has been the focus of neuroscience. In this article, we review the adjustment of basic fibroblast growth factor (bFGF) and epidermal growth factor (EGF) to the proliferation and differentiation of NSCs. DATA SOURCES: A computer-based online search of Medline database was undertaken to identify the related articles published in English from January 1998 to March 2006 by using the keywords of "bFGF, EGF, nerve stem cells". At the same time, Chinese relevant articles were searched in China National Knowledge Infrastruction published between January 2000 and March 2006 with the same keywords in Chinese. STUDY SELECTION: The data were selected firstly to look over the citations of every literature. Inclusive criteria: Articles related to the effect of bFGF and EGF on the proliferation and differentiation of NSCs. Exclusive criteria: Duplicate research or Meta analysis. DATA EXTRACTION: A total of 78 related articles were collected, of which 32 accorded with the inclusive criteria and 46 with duplicate or old contents literatures were eliminated. Among the 32 literatures, 8 involved in the research status of NSCs, 10 about the effect of bFGF on the proliferation and differentiation of NSCs and the mechanism, 4 involved in the effect of EGF on the proliferation and differentiation of NSCs and the mechanism, respectively, 8 related to the effect of bFGF and EGF together, and 5 related to the comparison of the effect of bFGF and EGF. DATA SYNTHESIS: ①NSCs are self-renewed, and can differentiate into different stem cells and mature tissue cells in different microenvironment. Many cytokines in the microenvironment play essential roles in the differentiation direction of NSCs. ②bFGF has strong improvement effect on the proliferation of NSCs and can activate the potential regeneration capacity of neuronal precursor cell in distinct areas of central nervous system, proliferation and differentiation of cells present bFGF concentration dependent. ③EGF can improve the growth of NSCs, and promote them differentiate into neuron and glial cells; its effect of facilitating cell proliferation also presents concentration dependent. ④To elevate the efficacy of proliferation and differentiation of NSCs, allied application of bFGF and EGF is usual in NSCs culture. ⑤There is not a unified cognition to the effect difference of bFGF and EGF. CONCLUSION: bFGF and EGF have powerful effect to improve the proliferation and differentiation of NSCs; therefore, both of them are important neural somatomedin. Moreover, their effects present concentration dependent.

Objective To investigate the clinical effect of par ti al pulpotomy in the dreatment of complicated crown fracture of permanent inciso rs with pulp exposure. Methods 44 soldiers suffering from compl icated crown fracture of the incisors with exposure of pulp as a result of injur y 46 during training were enrolled for study. Altogetber teeth were treated with partial pulpotomy, and they were followed-up for 1 to 5 years. Result One of the teeth was found fo have pulp necrosis one year after treatm ent dut to falling off of the filling. The treatment failed in other toeth dut t o polpitis 2 to 4 years later. The treatment was successful in 42 teeth (91.3%) . Conclusion Partial pulpotomy was an effective treatment for c omplicated crown fracture of permanent incisors with exposureof pulp.