Impaired glucose tolerance is the prediabetic state of diabetes mellitus,and its main manifestation is postprandial hyperglycemia.Studies in recent years have suggested that the large vascular disease of the impaired glucose tolerance state is similar to diabetes mellitus.The relationship between impaired glucose tolerance and atherosclerotic disease is increasingly receiving attention.This article reviews the relationship between both of them.

Fibromuscular dysplasia, a cryptogenetic segmental, nonatherosclerotic, noninflamma-tory arterial disease that most commonly involves the renal and carotid arteries, is one of the causes of ischemic stroke in young adults. With the development of various angiographic techniques, the detection rate of fibromuscular dysplasia becomes higher and higher, This article reviews the advances in fibromuscular dysplasia.

Objective To observe the levels of serum hypersensitive C-reaction protein (hs-CRP) and its correlation factors in cerebral infarction patients with impaired glucose tolerance (IGT). Methods According to the result of glucose tolevance test (GTT),the 131 patients were divided into normal glucose tolerance group (NGT, n=41),IGT group (n=47),newly diagnosed type 2 diabetes mellitus (DM) group (n=43). The serum hs-CRP levels and some biochemical parameters were measured in 72 h after the onset. The common carotid artery(CCA) and carotid plaque were examined by color B type ultrasonography. Results The hs-CRP levels were gradually increased among NGT,IGT and DM groups. The average of hs-CRP levels in NGT,IGT and DM groups were 0.320 mg/L,1.435 mg/L,4.305mg/L respectively.By the charge of logaithm,there were significanty differenc among each group(P

AIM: To study the protective effect of bone marrow stromal cells (MSCs) on ischemia /reperfusion hippocampal slices. METHODS: Ischemia/reperfusion models of hippocampal slices from newborn rats were established. MSCs obtained from adult bone marrow were cultured, isolated and purified. Cell death was assessed using propidium iodide fluorescence. And brain-derived neurotrophic factor (BDNF) expression in MSCs was determined by immunocytochemistry and Western blot. RESULTS: Maximal dead cells appeared in hippocampal slices 3 to 7 days after reperfusion. When the slices were co-cultured with MSCs, only a few cells were dead. The protective effect of MSCs on the slices was diminished significantly when anti-BDNF antibody was added to the medium. The protein of BDNF was faintly expressed in MSCs under normal conditions. When MSCs were co-cultured with ischemia /reperfusion hippocampal slices, the expression of BDNF in MSCs was increased gradually especially when co-cultured for 3 to 7 days. However, MSCs co-cultured with normal hippocampal slices expressed BDNF at a lower level at any times of co-culture. CONCLUSIONS: In an in vitro model of simulated ischemia, MSCs reduce cell death. Ischemia/reperfusion hippocampal slices co-cultured with MSCs promote the expression of BDNF in MSCs, which in turn protect the ischemic neurons.

Objective To discuss the treatment strategy of medial collateral ligament and combined injury in the terrible triad of elbow.Methods The data of 21 patients with terrible triad of elbow who received treatment from February 2010 to April 2012 was retrospectively analyized.There are 17 males and 4females with12 cases left and 9 right elbows.The average age of them was 37.6 years (16-57).MRI examination was performed routinely,and used as guidance of treatment strategy of medial collateral ligament and combined injury.For the patients without or with partial damage of anterior bundle of medial collateral ligament(AMCL) injury while the continuity of ligament remains complete in MRI image,exploration and repair of the medial collateral ligament is not conventional.For the patients with MRI image showing AMCL avulsion or body disruption,we routinely used antero-medial approach to explore and repair,suture-anchors were used for suture the bony avulsion of the medial collateral ligament,body disruption of ligament and combined flexor-pronator teres complex injury were also be suture repaired.None of the patients used hinged external fixator during operation.A hinged brace was applied after operation.Results All patients were followed up for an average of 12.4 months (6-26).At the last follow-up,the average range of motion of the elbow was 135.2 ±10.2 degrees,average straight limited degrees,6.7±2.2 degrees,an average of 142±11.0 degrees of flexion.Mayo elbow performance score was 92 points (85-100).17 cases were excellent and 4 were good.Complications included:a transient ulnar nerve palsy in 3 cases,heterotopic ossification in 2 cases,tardive ulnar neuritis in 1 case,no elbow residual instability,dislocation,elbow stiffness and other complications.Conclusion Anterior bundle of medial collateral ligament avulsion or body disruption should be routinely suture repaired,which is in favor of restoring elbow immediate stability favoring restore elbow immediate stability.

BACKGROUND:With the increasing morbidity of type 2 diabetes, people should pay more attention to the early intervention of cardiovascular complications in order to reduce the incidence of its complications. OBJECTIVE:To observe the risk factors of type 2 diabetes combining coronary heart disease(CHD) and the images of coronary angiography. DESIGN:A cross-sectional observational study. SETTING:Internal medicine department of a municipal hospital. PARTICIPANTS:The study was completed in the Department of Endocrine Harbin First Hospital from May 1998 to May 2003.Inclusive criteria:Type 2 diabetic patients aged above 30 years old and combined with CHD with either sex, who met the diagnostic standard of diabetes set by ADA in 1997 and Naming and Diagnostic standard of ischemic heart disease set by WHO in 1979. Exclusive criteria:Patients suffering from severe heart,liver,kidney disease and serious infection,rheumatoid heart disease,pulmonary heart disease and so on.There were 98 inpatients, who met the above mentioned inclusive criteria, were set as the diabetic group with 56 males and 42 females,aged from 35 to 70 years old;and 85 CHD patients without combining diabetes admitted to hospital at the same time were chosen as the control group with 53 males and 32 females, aged from 40 to 75 years old. INTERVENTIONS:The blood glucose was observed with the glucose oxidase method,fasting insulin and C peptide with radioimmunoassay (RIA),glycosylated hemoglobin with affinity chromatography, triglyceride(TG),total cholesterol(TC),high density lipoprotein-cholesterol(HDL-C) and low density lipoprotein-cholesterol (LDL-C) with automatic biochemical analysis,and selective right coronary angiography was applied by JUDKINS method. Of coronary arteries. RESULTS:The comparison of the coronary angiographic images between the two groups showed that there was no significant difference in the lesion of left main trunk and circumflex artery between the diabetic group and control group(P >0.05);While there were more cases with lesion of anterior descending artery and right coronary artery in the diabetic group than in the control group(P< 0.05). The pathological changes in the diabetic group mainly manifested with lesion of three branches and single branch in which represented diffusive changes.Lesion of three branches was the main pathological change of coronary artery in type 2 diabetic patients with diffusive changes. CONCLUSION:With the extension of course of type 2 diabetes in patients,the incidence of CHD will gradually increase with extensive pathological changes and much severe conditions.

Objective To analyze the efficacy and safety of pramipexole in treating restless legs syndrome (RLS) to different races.Methods A search for randomized,double-blind,and placebocontrolled clinical trials of pramipexole in treating RLS using Pubmed was carried out.A meta-analysis of included clinical trials was performed with Revman 5.2.The efficacy was calculated based on the change of the weighted mean difference (WMD) with International Restless Legs Syndrome Study Group rating scale (IRLS) and the relative risk (RR) of response with Clinical Global Impression-Improvement (CGI-I) scale.Safety was assessed with RR of the adverse event (AE).Subgroup analysis was conducted in the white race subgroup and the yellow race subgroup,separately.Results A total of 6 clinical trials were included in this meta-analysis.The records of patients were pooled.Overall,WMD of the change in IRLS score was-4.72 (Z =6.57,P ＜ 0.01),which was-4.33 in white race subgroup (Z =3.90,P ＜ 0.01) and-4.52 (Z =42.28,P ＜0.01) in yellow race subgroup.Overall RR of response based on CGI-I was 1.64 (Z =10.39,P ＜0.01),which was 1.60 (Z =4.66,P ＜0.01) in white race subgroup,and 1.51 (Z =4.42,P ＜ 0.01) in yellow race subgroup.Overall RR for AE was 1.26 (Z =5.11,P ＜ 0.01),which was 1.26 (Z =2.27,P =0.02) in white race subgroup and 1.36 (Z =2.98,P =0.003) in yellow race subgroup.Conclusion To treat RLS,pramipexole is an effective and safe drug.The results are similar for both the white race and the yellow race.

Objective To study the biological effects of grape seed proanthocyanidin extract (GSPE) on human ovary cancer cells and to explore the molecular mechanism. Methods Human ovary cancer cell line SKOV3 were co-cultured with GSPE solution of the terminal concentrations of 25,50,100,200,400 ?g/ml respectively in 96-well plate. At 24,48,72 h after coculture,the following parameters were detected: cell growth curve,the inhibition rate of SKOV3 cells by MTT assay,DNA cycle by FCM,the apoptosis of SKOV3 by TUNEL and Annexin-V labeling method,the mRNA and protein expressions of survivin by semi-quantitative RT-PCR and Western blotting,respectively. Results GSPE dose-dependently inhibited the proliferation of the SKOV3 cells. Treated by GSPE,the progress of SKOV3 cells at S stage into G/M stage was inhibited. TUNEL showed that treated by 25 ?g/ml GSPE for 24,48 h,the apoptotic rates of SKOV3 cells were 31.98%,45.78% respectively. Annexin-V showed that after incubation with 25 ?g/ml GSPE for 24 h,the apoptotic rate was 14.68%. The survivin mRNA and protein expressions were both down-regulated. Conclusion GSPE inhibits the proliferation of malignant human ovary cancer cells and induces their apoptosis. Expression of survivin mRNA and protein may be related to cell growth inhibition and to the apoptosis mediated by GSPE in vitro.

Objective To investigate the correlation between leukoencephalopathy and atherosclerosis. Methods 238 patients were enrolled. All the patients were underwent brain MRI and carotid and femoral artery duplex ultrasonography after hospitalized. The atherosclerotic plaque, intima-media thickness (IMT), peak systolic velocity (Vp) were measured with ultrasonography. The data was analyzed with SPSS 13.0 software. Results The leukoencephalopathy of the patients positively correlated with age, hypertension, serious of atherosclerosis and carotid IMT, negatively correlated with carotid Vp, but did not correlated with vertebrarterial Vp. Conclusion The leukoencephalopathy positively correlate with some atherosclerotic risk factors, the serious of atherosclerosis, and anterior circulation disorder, but do not correlate with posterior circulation.

Objective To investigate the clinical outcomes of minimally invasive percutaneous nephrolithotomy(MPCNL)in the treatment of lower caliceal calculi.Methods We retrospectively re- viewed the clinical outcomes and complications of 33 patients who underwent MPCNL for lower caliceal cal- culi from March 2001 to April 2005.The average diameter of the calculi was 2.8 cm.Single tract nephrosto- my was performed in all 33 cases;among them renal access was obtained through a middle calyx in 10 cases and a lower calyx in 23.Nine cases had F14 renal access;and 24 cases,F16.Results Of 33 cases,28 (85%)achieved stone-free at 1 session.A second-look was needed in 3 cases due to intraoperative bleed- ing;ESWL,in 1 case with residual,calculi;no treatment,in 1 case with residual calculi＜4 ram.The mean operative time was 93 min;mean blood loss was 113 ml;mean hospital stay was 11 d.Blood transfusion was needed in 1 patient who suffered from hepatic cirrhosis preoperatively;another experienced severe bleeding 7 d after operation and was cured with hyperselective spongia gelatinosa embolization of the renal artery.Fol- low-up was available in 19 cases for 2-48 months,and no recurrence of renal calculi was noted.Conclu- sions Minimally invasive percutaneous nepbrolithotomy has advantages of safety,less invasion,and easy re- covery for the treatment of lower caliceal calculi.