It is well known that the macrophages play an important defensive role in the innate immune system. During recent years, with the introduction of the concept of chronic low-grade inflammatory diseases and their further intensive study, the activation and balance of macrophage, as well as its inflammatory effects in chronic lowgrade inflammatory diseases, such as obesity, type 2 diabetes, atherosclerosis, and non-alcoholic fatty liver, are gradually becoming a hot topic of current research. The present article mainly gives an overview of the important role played by macrophages in the inflammatory effects in these diseases.

Pathogenic diagnosis is very important for the management of sellar mass.Many reasons can cause sellar mass,which makes it easily to be misdiagnosed and subsequently lead to mismanagement.The aim of this article is aimed to catch physicians′ attention to the differential diagnosis of sellar mass,in order to raise the management level of sellar mass and to reduce its misdiagnosis and mismanagement.

AIM: To search for new candidate partners of human cell division cycle gene 14A (hCDC 14A) and explore their functional relationships.METHODS: Yeast two-hybrid screening was employed to find hCDC 14A new partners. Physical interaction between two proteins was verified using Pulldown and co-immunoprecipitation assays. Subcellular localizations were revealed by immunofluorescence. In vivo ubiquitination test implied their potential functional relationship.RESULTS: BRAP2 (BRCA1 associated protein 2) was found to be a new candidate partner of hCDC 14A. hCDC 14A was modified by ubiquitination, and BRAP2 increased this modification in vivo. As expected, hCDC 14A and BRAP2 co-localized on mitotic spindles in HeLa cells.CONCLUSION: BRAP2 may be an ubiquitin E3 ligase of hCDC 14A.

Objective To assess the efficacy of Ezscan in evaluating the risk of cardiac autonomic neuropathy (CAN) in diabetes. Methods This study included 144 patients with diabetes. Their serum lipid profile and HbA1c were determined. The heart rate variability was assessed by Holter, and the cardiac autonomic neuropathy by classic experiments. Meanwhile, Ezscan was carried out. Results There was a positive correlation between low frequency (LF) measurements by Holter and Ezscan score( r=0. 39, P＜0. 01 ), so did LF/HF and Ezscan score( r=0. 28, P＜0. 01 ). Correlations between Ezscan score and other Holter parameters were weaker. There was no correlation between HbA1c and LF measurements. In patients with positive classic experiments, the sensitivity and specificity of Ezscan were 58. 3% and 57.8% respectively. Conclusions Ezscan test is a valuable screening procedure for detecting diabetic complications. It is more facilitative and takes shorter time than does the classical autonomic function assessment.

Objective To explore the characteristics of the gene expression in Cushing′s adrenal corticoadenoma and its associated molecular mechanism. Methods cDNA libraries of human normal adrenal and the adenoma were constructed. Large scale sequencing and bioinformatics were used. Results From the tumor library, 2089 expressed sequence tags (ESTs) were obtained with a successful rate of 98.9%. The functional distribution of the known genes in the tumor coincided with that in normal adrenal. Some synthases such as 3bHSDⅡ and P450c17A involved in steroidogenesis were expressed more highly in the adenoma than those in normal adrenal, especially 3bHSDⅡ. By comparison with the expression abundance of genes and statistic analysis, the differences were significant in 45 genes between the tumor and normal adrenal libraries. Interestingly, some genes associated with tumorigenesis, including heat shock protein 90, metallopanstimulin (MPS1), adenine nucleotide translocators etc, were highly expressed in the adenoma. However, those genes related to apoptosis and suppressing proliferation were not found in the tumor library. Conclusion The adenoma shows exuberant activities in steroid synthesis. Not only does the tumor highly express the genes associated with tumorigenesis, but also those related to apoptosis and suppressing proliferation lowly existed in the tumor.

AIM: To clone and express the gene of SLC24A6, which provide the basis to illuminate the relationship between the SLC24A6 and insulin release. METHODS: The gene expression of SLC24A6 was analyzed in the insulinoma and normal pancreatic tissues by RT-PCR. The full-length cDNA sequence was subcloned into pET32a vector, and induced expression and purified in ROSSET (DE3) strain. At the same time, the ORF of SLC24A6 was cloned into green fluorescence protein vector pEGFP-C3 to study the location of SLC24A6 in the mouse insulinoma ?-TC3 cells. RESULTS: The mRNA expression of SLC24A6 in the human insulinoma tissue was significantly higher than that in normal pancreatic tissue. The fusion protein of SLC24A6 was a 80 kD protein and was purified successfully by prokaryotic vector in ROSSET strain. The localization of SLC24A6 in the mouse insulinoma ?-TC3 cells was located in the membrane of the cells. CONCLUSION: SLC24A6 might be related with insulin release. The prokaryotic expression of SLC24A6 provides the basis for the study on biological function and protein structure, and the location of SLC24A6 in the insulinoma cell will throw light on the relationship with insulin release.

Objective To understand the pathogenesis of primary hypothyroidism associated with polymyositis-like syndrome.Method Four cases were presented and the clinical characteristics were analyzed.Results All of the four patients were male.Complaints of weakness primarily affecting proximal muscles and elevation of muscle enzymes were presented.Primary hypothyroidism was diagnosed after clinical examination.Complaints of weakness and the elevated muscle enzymes were all improved after the substitution of thyroxine.Conclusion Hypothyroidism could cause polymyositis-like syndrome,and thyroid function should be screened when elevation of muscle enzymes is presented.

Objective To understand treatment outcomes of patients diagnosed with type 2 diabetes aged over 30 years in Jiangninglu Neighborhood of downtown Shanghai. Methods Total 642 patients diagnosed as type 2 diabetes aged over 30 were investigated by cluster sampling in Jiangninglu Neighborhood of downtown Shanghai. Status of optimal control of diabetes in them was analyzed based on the recommendations proposed by International Diabetes Federation (IDF) for Western Pacific Region. Results and serum level of glycosylated hemoglobin Alc (HbAlc) of less than 6.5% was achieved in 37.5% (241/were achieved in 23.8% (153/642) and 18.1% (116/642) of them, respectively, and beth systolic and mmol/L was achieved in 21.7% (139/642) of all the participants investigated, triglyceride of less than 1.5 mmol/L in 46.6% (299/642), low-deusity lipoprotein-cholesterol (LDL-C) of less than 2.5 mmol/L in 23.7% (152/642) and high-density lipoprotein-cholesterol of greater than 1.1 mmol/L in 62.1% (399/of their blood glucose, blood pressure and serum LDL-C (defined as HbAlc less than 6.5%, blood pressure less than 130/80 mm Hg and LDL-C less than 2.5 retool/L). Conclusions Only 2.6% of all the patients diagnosed with diabetes aged over 30 in downtown Shanghai get optimal control of their blood glucose, blood pressure and serum lipid, so comprehensive prevention and control for diabetes shall be strengthened for them at community-level of urban areas.

Objective To improve the recognition of pituitary hyperplasia secondary to primary hypothyroidism by analyzing clinical and imaging data. Methods The clinical features, hormone data,imaging findings, and treatment were reviewed in 32 patients with pituitary hyperplasia secondary to primary hypothyroidism in Huashan Hospital from 1999 to 2008. Results Thirty-two patients, most juvenile,presented clinical and imaging features suggestive of functional primary pituitary adenoma. The dose of levothyroxine was increased to maintain the thyrotropin concentration at normal values. Following adequate thyroxine replacement, pituitary hyperplasia regressed on average within 6 months. Conclusions Pituitary hyperplasia secondary to primary hypothyroidism seems to be quite prevalent in children and adolescents.Complete regression will be achieved with thyroxine replacement therapy.

A retrospective analysis was made on clinical data of 230 cases of metabolic syndrome (MS) and 239 cases of non-MS admitted to department of cardiology and endocrinology of Huashan Hospital from July 2005 to August 2009.Multiple linear regression analysis was performed to assess the association between levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and potential influencing factors.Covariance analysis was used for group comparison.Multiple linear regression analysis demonstrated that age,body mass index,systolic blood pressure,diastolic blood pressure,insulin resistance index,triglyceride,low density lipoprotein-cholesterol,creatine,left atrial diameter,left ventricular posterior wall dimensions,left ventricular ejection fraction were independent predictors for plasma levels of NT-proBNP in those subjects(P ＜ 0.05).Covariance analysis showed that plasma levels of NT-proBNP in MS group were significantly lower than those in non-MS group ( P ＜ 0.05).Further analysis found that plasma levels of NT-proBNP in MS patients with high triglyceride and body mass index,but normal systolic and diastolic blood pressure,normal fasting plasma glucose were significantly lower than those in non-MS group ( P ＜ 0.05 ).The results indicate that decreased plasma levels of NT-proBNP might be related to lipids disorder and obesity of MS patients.