Diabetes mellitus impacts patient survival and quality of life mainly due to its acute and chronic complications.Pancreas transplantation may restore normoglycemia and reduce the complication of insulin-dependent diabetes,thus improving the quality of life and prolonging patient's survival.Although pancreas transplantation requires major surgery and life-long immunosuppression therapy,it currently remains the gold stand for patients with type 1 diabetes mellitus,who do not respond to conventional therapy.Meanwhile,potential of the islet transplantation,insulin-producing cells replacement therapy,and artificial pancreas as the alternative to pancreas transplantation are under investigation.

More and more extrapancreatic actions of incretin-based therapies have been demonstrated and recently case reports have linked glucagon-like peptide-1 (GLP-1) receptor agouist therapy with the improvements in psoriasis.Psoriasis is a common skin disorder characterized by chronic inflammation.Epideminological studies have showed that patients with psoriasis exhibit increased rates of cardiovascular disease,obesity,and type 2 diabetes,owing probably to the enhanced local and (or) systemic inflammation.The observations of anti-inflammatory actions of GLP-1,which exerts direct and indirect actions on immune function,together with the improved psoriasis,offer new insights into the investigation of non-classical anti-inflammatory actions of incretin-based therapeutics and provide a new direction for the research of the novel clinical application of GLP-1.

Based on concerns during stents manufacturing, the tubing purchase specifications of coronary stents have been proposed, and the key role of process inspection for judging the qualified tubing have been justified. By comparing the incoming inspection and the process inspection, it is concluded that the process inspection, as basis for optimizing tubing, is indispensable for selecting and confirming the tubing.

Amino acids (AA) as substrates of gluconeogenesis could promote endogenous glucose production.Some AA can enhance insulin secretion. Recently,many studies have found that some AA can also activate mammalian target of rapamycin-S6 kinase 1 ( mTOR-S6K1 ) pathway,resulting in maintaining pancreatic β cell function on one hand,and on the other hand,inhibiting insulin signal transduction of insulin-sensitive cells and thus causing insulin resistance.

Objective To observe the cognitional differences between teachers and students concerning teaching objective,curriculum,teaching methods and effect and teaching reform and to pro-vide references for teaching reform. Methods Medical humanistic questionnaire was designed to survey teachers and students. Data were processed by SPSS 18.0 and were analyzed by Chi-square. P value smaller than 0.05 signifies significant differences. Results There were significant differences in cognition of medical humanistic ability,emotion controlling ability,curriculuma provision and teaching methods between teachers and students.12.9% teachers and 41.3% students considered that the opportunity of medical humanistic practice was plenty while 55.7%teachers and 35.3%students thought that the univer-sity attached little importance to medical humanistic teaching. Conclusions Key points of humanistic reform include making clear the teaching objectives,emphasizing practice of medical humanistic teach-ing,improving curriculum and deepening appraisal reform.

As for pediatric patients,antibacterial drugs are the most common prescription drugs.These agents play a significant role in reducing the incidence and mortality of human infections.However,at the same time,some related adverse reactions appeared,such as the impact on intestinal microflora colonization.Intestinal microbial population has great importance in regulating body's metabolism.If early use of antibiotics in life,the composition of the intestinal microbiota will be destroyed,and resulting in obesity.Animal experiments showed that low-dose antibiotics may promote an increase in body weight,and the use of antimicrobial drugs in the early life was more effective than that in late stage.Currently,available human epidemiological investigation indicated that antibacterial drugs had a similar effect in human.Gut flora in early life is essential for the later metabolism of body,but it is susceptible to interference.Using probiotics after the application of antimicrobial drug may be beneficial to improve the balance of intestinal microflora.This may be a new direction to prevent obesity after the early use of antimicrobial drugs.Now,the domestic and foreign reports were combined to elaborate the antibacterial drug metabolism in animals,the influence of body quality on the quality of the human body and the corresponding measures after application of antimicrobial agents.

Objective To compare open reduction and internal fixation (ORIF) and minimally invasive percutaneous plate osteosynthesis (MIPPO) in the operative treatment of complicated proximal humeral fractures.Methods From January 2014 to October 2015,55 complicated proximal humeral fractures were treated at our department.They were 32 men and 23 women,from 21 to 81 years of age (average,51 years).According to Neer classification,34 cases belonged to three-part fractures and 21 ones to four-part fractures,14 of which were complicated with dislocation.Of them,35 received ORIF and 20 underwent MIPPO.The 2 groups were compared in terms of operation time,intraoperative blood loss,incision length and Neer scoring of the shoulder function at the final follow-ups.The 2 groups were compatible without significant differences in preoperative demographic data (P ＞ 0.05).Results The 55 patients were followed up for 6 to 12 months(mean,9 months).The operation time (100.5 ± 10.2 min),intraoperative blood loss (80.0 ± 10.5 mL),and incision length (7.5 ± 3.2 cm) in the MIPPO group were significantly better than those in the ORIF group (120.0±10.1 min,200.5±10.2mL,and10.5±5.3cm,respectively) (P ＜0.05).According to the Neer scoring of the shoulder function at the final follow-ups,the good to excellent rate was 71.4％ (25/35) in the ORIF group and 85.0％ (17/20) in the MIPPO group,showing a significant difference (P ＜ O.05).The incidence of humeral head necrosis was 15 in the ORIF group,significantly higher than that (3) in the MIPPO group (P ＜ 0.05).Conclusion In treatment of complex proximal humeral fractures,compared with ORIF,MIPPO may lead to less damage to local blood supply,less trauma,and quicker functional recovery due to early functional exercise.

Diabetic nephropathy( DN) is one of the main manifestations of diabetic microvascular dis?ease,and it is a major factor in the death of diabetes.At present,the treatment of DN is mainly focused on the control of high blood sugar and high blood pressure.Although angiotensin converting enzyme inhibitors and angio?tensin II receptor antagonists can slow the progression of DN,there were a lot of patients deteriorate to renal fail?ure.The role of vitamin B supplementation in preventing microvascular complications of diabetes has already been a focus of research for some years.In this paper,the role of B vitamins in the pathogenesis of diabetes mellitus and DN,effect of vitamin B supplementation on treatment in DN were discussed.

Objective To evaluate the quality of life (QOL) in continuous ambulatory peritoneal dialysis (CAPD) patients and analyze the non-medical factors influencing QOL in order to explore the possible way to improve QOL in peritoneal dialysis (PD) patients.Methods Seventy-nine chronic renal failure patients treated with PD included in the present study.Investigated their age,sex,working status,education,medical burden and family support.Patients' QOL was evaluated by international questionnaire-KDQOL/SF-36.Patients' anxiety/depmssion status was evaluated by Hamilton depression questionnaire.Results (1)The SF-36 with its eight scales of CAPD patients were markedly lower than ordinary people (P＜0.05 or＜0.01).(2) Comparing with those on work,the patients without work got lower SF-36 scores[(45.78±16.93) seores vs (32.65±12.26) scores,P＜0.05].Comparing with those who had medical care,the patients without medical care got much lower SF-36 scores [(49.62±13.20) scores vs (33.85±6.24) scores,P＜0.05].Patients with higher income had better QOL.(3) Patients cared by their children and companion had the higheat SF-36 [(68.33±14.73) scores],while those cared by nursemaid or themselves had the lowest [(27.98±15.77) scores].(4) Among the 79 patients,43 patients (54.4%) were anxiety and 12 patients (15.2%) were depression.QOL was negatively correlated with anxiety index and depression index.Conclusion The QOL of CAPD patients are remarkably low,which is deeply influenced by many non-medical factors such as working status,medical burden,family support and emotional status.

Neonatal hypoglycemia is a common clinical disease.Hypoglycemia can lead to severe acute and long-term dysfunction of nervous system.The several aspects of neonatal hypoglyccmia such as the definition,diagnosis of brain injury,risk factors,treatment,detection method and long-term follow-up were reviewed.