LADA China Study is the first nation-wide muliicenter study for adult onset latent autoimmune diabetes (LADA) in Chinese.We have published the data on Diabetes in 2013.In this article,we briefly introduce the results and the significance to clinical practice.

Objective To investigate the pathogenic bacteria types and distribution characteristics of critical patients with lower respiratory tract infection in neurosurgery department,and to analyze the high risk fac?tors of lower respiratory tract infections. Methods A retrospective analysis of 80 cases of critical patients with lower respiratory tract infection in neurosurgery department of General Hospital of People Liberation Army from April 2013 to April 2014 was carried out. The pathogenic bacteria types and distribution characteristics of lower respiratory tract infection were analyzed by means of bacterial identification,and single factor and multi factor Lo?gistic regression analysis was carried out to analyze the related factors of lower respiratory tract infection.Results One hundred and thirty?four strains of pathogenic bacteria were cultured from sputum of 80 cases of patients. Among which the gram negative bacteria were 109 strains,accounting for 81.34%(109/134),while the Gram positive bacteria were 17 strains,accounting for 12.69%(17/134) and the fungi were 2 strains,accounting for 1.49%(2/134).The proportion of three kinds of pathogenic bacteria had statistical significance(P=0.004, 0.001). The single factor Logistic regression analysis showed that,younger age,use of ventilator,use of antimi?crobial drugs and pulmonary infection rate were protective factors of lung infection(OR(95%CI)=0.586(0.475-0.722),0.708(0.574-0.873),0.827(0.697-0.981);P=0.043,0.007,0.000);disturbance of consciousness, tracheotomy,insert gastric tube, surgery and pulmonary infection incidence were risk factors for lung infection (OR(95%CI)=4.769(1.069-21.276),11.612(5.438-24.792),22.989(19.385-27.263),10.426(8.789-12.361);P=0.001,0.008,0.005,0.002).The multi factor Logistic regression analysis showed that there was a significant correlation between the trachea incision, the consciousness and the lower respiratory tract infection (OR(95%CI)=4.627(2.143-20.645),10.412(2.334-46.455);P=0.009,0.002).Conclusion Patients with conscious disturbance and tracheotomy were more likely to have lower respiratory tract infections. The pathogens of lower respiratory tract infections are Gram?negative bacteria,and the majority of pathogens are high resistance, and it is multi drug resistance.

Incretin-based therapies are now being widely used in type 2 diabetes as a new type of antidiabetic drugs,with their efficacy and safety having been confirmed.However,there are relatively few researches carried out in type 1 diabetes.A variety of clinical studies (mainly in type 2 diabetes) have shown that incretin-based therapy could effectively improve glucose control.In this article,the clinieal application of incretin-based therapy in type 1 diabetes will be reviewed and commented from the prospective of clinical studies,combined with animal experiments.

Type 1 diabetes mellitus(T1DM) is a chronic autoimmune disease.Prospective studies carried out in T1 DM pre-diabetic relatives have shown that the process of β-cell degeneration can take place before the disease manifests itself clinically.Scholars have made several breakthroughs in immune therapy for T1 DM.This paper will make a review of the latest progress in the antigen-specific,antibody-based,cell-based,and other immunotherapies of T1DM.

OBJECTIVE:To prepare the Compound anisodamine and neostigmine sustained-release tablet and study the in vitro drug release behavior. METHODS:Using raceanisodamine and neostigmine methyl sulfate as main medicines,hydroxypropyl meth-yl cellulose as sustained release skeleton material,magnesium stearate as the lubricant,polyvinyl pyrrolidone as the adhesive,pre-gelatinized starch as the thinner,microcrystalline cellulose as the disintegrant and filler,Compound anisodamine and neostigmine sustained-release tablet was prepared by wet granulation method and direct compression method. The in vitro cumulative release rate within 12 h of the 2 main medicines was detected by HPLC method. RESULTS:Compound anisodamine and neostigmine sus-tained-release tablet was successfully prepared,and the in vitro release was basically completed within 12 h,with accumulative re-lease rate of 91.3% for anisodamine and 96.5% for neostigmine. CONCLUSIONS:Compound anisodamine and neostigmine sus-tained-release tablet that can cumulatively release for 12 h is successfully prepared.

Intensive attention has been drawn to macrophages in obesity after the discovery of macrophage infiltration in adipose tissue. This review updates of adipose tissue macrophages in the immune-pathophysiology of obesity, including new progression on the adipose tissue macrophages phenotype and the potential of beige fat induction by M2 macrophage, which inspires a novel therapy for obesity and insulin resistance.

Objective To evaluate the video-assisted thoracoscopic surgery(VATS) in the diagnosis and treatment of open thoracic traumas. Methods From July 2003 to July 2008,video-assisted thoracoscopic surgeries,including thoracic exploration,repair of the pulmonary laceration,parietal pericardium and diaphragm,hemostasis,evacuation of the clotted hemothorax,and mini-incision thoracotomy,were carried out in 64 selected patients with open thoracic traumas. Results Via VATS,all the 64 patients were diagnosed accurately: pulmonary laceration in 43(56 lesions),pericardiac rupture in 7(one of them showed right ventricular rupture),diaphragmatic rupture in 9(5 of them were complicated with spleen rupture,1 with hepatic rupture,and 1 with gastric rupture perforation),single intercostal vessel injury in 5,and combined intercoastal vessel injury in 3.The procedures involved VATS pulmonary laceration repair in 24(combined with thoracic wall hemostasis in 2),VATS combined mini-incision thoracotomy pulmonary laceration repair with Endo-GIA in 11(silk suture was employed in 6,and pulmonary wedge resection in 2).Through VATS procedure,hemostasis and repair were completed for pericardiac repair in 3,and diaphragmatic repair in 5.Thirteen cases were converted to open thoracic surgery.The duration of VATS procedure ranged from 32 to 124 minutes with a mean of 65.8 minutes.After the procedure,6 patients developed pneumothorax,4 showed mild subcutaneous emphysema,and 9 had slight hemoptysis in 1 to 12 days after the treatment.The patients were followed up for 2 to 60 months(mean,28.5 months).Chest X-ray performed during the period showed no pleural effusion,pneumothorax or other trauma-related complications.Conclusion VATS is effective for the diagnosis and treatment of open thoracic traumas with less surgical injuries and good outcomes.

AIM:Xilei Powder,a traditional Chinese prescription,has been used to treat wounds for hundreds of years,but the mechanism has not been fully understood.METHODS:The effects of Xilei Powder on fibroblast proliferation,collagen accumulation,matrix metalloproteinases-2,9(MMP-2,9)activities and tissue inhibitor of metalloproteinase 1(TIMP-1)production were investigated by MTT,chloramine T method,gelatin zymography and enzyme-linked immunosorbent assays(ELISA),respectively.RESULTS:The aqueous extract of Xilei Powder significantly promoted fibroblasts proliferation in a time and concentration manner,the population doubling time(125 ?g/mL)was 33.8 h,it also significantly(P

Objective:To compare the therapeutic effects by different longitude margins of the gross tumor volume (GTV) based on elec-tive nodal irradiation (ENI) and to investigate the optimization of clinical tumor volume (CTV) in the radical chemoradiotherapy of esophageal squamous cell carcinoma (ESCC). Methods:ESCC patients treated with chemoradiotherapy for the first time in the First Af-filiated Hospital of Xiamen University from May 2009 to November 2012 were retrospectively studied. All patients were treated with ENI for radical radiotherapy, and the patients were divided into two groups:CTV1 group (with longitudinal external expansion length of less than 3 cm) and CTV2 group (with longitudinal external expansion length of more than 3 cm). The survival time and occurrence of side effects in patients were compared. Results:Among the 142 cases of patients, 82 and 61 cases were classified under CTV1 and CTV2, respectively. No significant difference in the overall survival (OS) and local recurrence-free survival (LRFS) rates was observed af-ter 1, 3, and 5 years of treatment between the two groups. The occurrence of side effects, such as bone marrow suppression, radiation pneumonitis, radiation esophagitis, and esophageal fistula, was less than 5%in both groups, and the data show that the side effect oc-currence in CTV1 was significantly lower. Conclusion:In the radical chemoradiotherapy of esophageal cancer using ENI, the OS rate of patients with a delineated CTV according to a 3 cm GTV longitudinal external expansion length is not lower than that of patients with a delineated CTV according to a GTV longitudinal external expansion length of more than 3 cm. The results provide a reference for the optimization of CTV in the radical chemoradiotherapy of ESCC.

BACKGROUND:Tranexamic acid administered either in intra-articular route or in intravenous route can significantly reduce blood loss during total knee arthroplasty. Recent studies are stil controversial in application mode of tranexamic acid in the clinic.
OBJECTIVE:To compare the clinical outcomes of tranexamic acid in intra-articular route and intravenous route during total knee arthroplasty.
METHODS:PubMed, OVID, Web of Science, and EMBASE were searched to identify randomized control ed trials concerning the comparison of tranexamic acid in intra-articular route and intravenous route during total knee arthroplasty published before 1 May 2015. Transfusion rate, hemoglobin decline, drainage volume and thromboembolic complication rate were considered as indexes to evaluate the clinical effect, for meta-analysis.
RESULTS AND CONCLUSION:Six randomized control ed trials involving 847 patients were included. Meta-analysis results showed no significant difference between intra-articular and intravenous administration of tranexamic acid in terms of transfusion rate, hemoglobin decline, drainage volume, total blood loss, and thromboembolic complication rate. Subgroup analysis for dose regimen showed that when occlusion time of drainage tube was<2 hours. Intra-articular route of tranexamic acid showed high drainage volume and hemoglobin decline compared with the intravenous route of tranexamic acid (P<0.01). Results confirmed that during total knee arthroplasty, clinical effects of intra-articular and intravenous routes of tranexamic acid are similar during total knee arthroplasty. Moreover, it is recommended that occlusion of drainage tube can be conducted for 2 hours in intra-articular route of tranexamic acid.