Objective To explore the relationship between homocysteine (Hcy)expression and diabetic ret-inopathy(DR)in patients with type 2 diabetes mellitus (T2DM).Methods 79 patients with T2DM were selected and divided into proliferative DR group (n =26),background stage of DR group (n =25)and without DR group(n =28)according to the degree of retinopathy.28 cases of healthy physical examination were involved as control group. Blood glucose levels,Hcy and clinical significance were detected and compared among the groups.Results The FPG and Hcy levels in the control group,without retinopathy group,background stage of DR group and proliferative DR group showed an increasing trend,there were significant differences among groups (F =448.53,174.25,all P <0.01).The FPG level of the control group was (4.86 ±0.42)mmol/L,which was significantly lower than the back-ground stage of DR group[(8.73 ±0.48)mmol/L,t =31.59,P <0.01 ]and the proliferative DR group[(10.9 ± 0.95)mmol/L,t =30.59,P <0.01].The FPG level of proliferative diabetic retinopathy DR group was also signifi-cantly higher than without retinopathy group(t =17.72,P <0.01).The Hcy level of the control group was (7.93 ± 0.70)μmol/L,which was significantly lower than the background stage of DR group[(9.45 ±0.83)μmol/L,t =7.69,P <0.01]and the proliferative DR group[(13.55 ±1.56)μmol/L,t =11.0,P <0.01].The Hcy level of the proliferative DR group was also significantly higher than without retinopathy group(t =12.52,P <0.01).Conclusion Hcy may involved in the process of T2DMwith DR,it may be used as an important reference index for the degree of retinopathy.

Metabolic surgery has brought new hope for obese T2DM patients. Control of long‐term complications and integrated management after metabolic surgery are important for patients to obtain a long‐term benefit. Cooperation of multidisciplinary teams plays an indispensable role in this systemic work.

Objective .To evaluate the role of cystatin c in the risk judgement of coronary artery disease. Methods 77 patients with coronary artery disease were involved in the study.They were divided into two groups:Group 1 were patients with angiographically diagnosed coronary artery disease ( CAD) with their first acute coronary syndrome ( n=55);Group 2 were patients who had clinically diagnosed coronary disease but were negative on angiog-raphy ( n=22) .Serum Cys C levels in the two groups and the correlation to CAD were analyzed.Results Serum Cys C levels in patients of Group 1 were higher than that of Group 2 [(1.23 ±1.07)mg/L vs.(0.71 ±0.32)mg/L,P=0.002],but no significant difference was found between the two groups in crea levels [(123.76 ±80.44)μmmol/L vs.(117.63 ±65.43)μmmol/L,P=0.230].A ROC analysis revealed that there was a significantly higher risk of ACS above a cystatin c level of 0.875mg/mL (sensitivity:84.3%,specificity:38.8%).A similar analysis carried out for eGFR did not find any significant cut-off points above which risk of ACS was higher.Conclusion The data showed that a high level of cystatin c level is a risk factor for ACS.This could play an important role in the early diag-nosis and prevention of adverse cardiovascular events.

Objective To investigate the effect of dyslipidemia on retinol binding protein4(RBP4) and their correlation in type 2 diabetes(T2DM ) patients .Methods A total of 55 patients with T2DM were selected into T2DM group ,51 healthy persons were selected into control group .Serum total cholesterol(CHOL) ,high density lipoprotein cholesterol(HDL-C) ,low density lipoprotein cholesterol(LDL-C) ,triglyceride(TG) ,apolipoprotein A1(ApoA1) ,apolipoprotein B(ApoB) ,glucose(Glu) and RBP4 were detected by automatic biochemical analyzer ,and compared between the two groups ,the relationship between TG and RBP4 was analyzed .Re-sults The levels of serum RBP4 in patients with T2DM was significantly higher than that of control group .Positive correlation was observed between RBP4 and TG in patients with T2DM (r=0 .333 ,P=0 .013) ,however ,no correlation was found in patients in control group(r=0 .065 ,P=0 .614) .Serum RBP4 in patients with TG>1 .70 mmol/L were significant higher than those patients with TG≤1 .70 mmol/L (P=0 .011) .Conclusion High level of serum RBP4 was observed in patients with T2DM ,and positive correlated with TG ,which means level of RBP4 might be affected by TG .

Multiple myeloma (MM) is a clonal plasma cell malignancy, a low proliferative and low apoptotic activity molecular cloning of a disease, which indicates that apoptosis inhibition may play an important role in the pathogenesis of MM. Therefore, the study of MM pathogenesis-related promoting apoptosis genes/proteins and inhibiting of apoptosis genes/proteins, as well as the correlation between them provides a new strategy for molecular targeted therapy.

Stem cell (SC) is a class of initial cells with potential self renewal and differentiation ability.Under certain conditions,it can proliferate and differentiate into various functional ceils.Nucleoprotein Oct-4,Nanog and Sox2 are three major transcription factors,which play central roles in maintaining the pluripotent characteristics and inhibiting SC differentiation.Cancer stem cell(CSC) theory supposed that there is also existing SC-CSC possessing potential self renewal and differentiation abilities in tumor tissues.It is the SC properties of CSC that result in tumor's invasive growth,metastasis and resistance to treatment.Therefore,looking for CSC and determining their markers become an important direction for cancer research.And the introduction of Oct-4,Nanog and Sox2 into CSC research field is undoubtedly the most exciting forefront.

Epidemiological studies are important methods to discover the characteristics of diabetes mellitus,which are also helpful in improving the effectiveness of prevention and management of the diseases.Continuous improvement in the design and implementation of epidemiological studies itself would have great significance.

On the basis of a retrospective summary of the policies for foreign-invested hospitals in China,this paper analyzed the main issues facing wholly foreign-owned hospitals and suggested a basket of strategies to promote the development of such hospitals in China (Shanghai)Pilot Free Trade Zone.

Objective To study the different clinical effects between the method ofperipheral iridectomy+trabeculectomy combined with cataract extraction with small incision+intraocular lens implantationand the method ofperipheral iridectomy+trabeculectomy combined with cataract with phacoemulsification+intraocular lens implan-tation,so as to provide guidance for clinic.Methods 40 cases were randomly divided into A and B groups,and A group included 19 patients (31 eyes),while B group included 21 patients (37 eyes).A group was treated with the peripheral iridectomy +trabeculectomy combined with cataract extraction with small incision +intraocular lens implantationmethod,and B group was cured with the method ofperipheral iridectomy+trabeculectomy combined with cataract with phacoemulsification +intraocular lens implantationmethod.In each group,the eye pressures, visual acuity,central anterior chamber depths of before and after treatment were compared to study the clinical effect. And after treatment,the improvement amount of eye pressure,visual acuity,central anterior chamber depths and the complication rates were compared between the two groups,so as to determine the better method.Results After treatment,the eye pressure,visual acuity,central anterior chamber depths in A group were significantly improved [(21.71 ±10.17)mmHg,(0.29 ±0.09)and (1.97 ±0.47)mm,t=11.12,6.93,17.39,all P<0.05].The eye pressure,visual acuity,central anterior chamber depths in B group were significantly improved[(19.45 ±9.54)mmHg, (0.35 ±0.16)and (1.98 ±0.39)mm,t=6.52,5.78,17.78,all P<0.05].After treatment,the eye pressures in A and B groups were cut down[(21.74 ±10.17)and (19.45 ±9.54)mmHg],and there was no statistical significant difference between the two groups (t=0.96,P=0.17).The visual acuity in A and B groups were improved[(0.29 ± 0.09)and (0.35 ±0.16)degrees],and there was no statistically significant difference between the two groups (t=1.86,P=0.97).The central anterior chamber depths in A and B groups were improved[(1.97 ±0.47)and (1.98 ± 0.39)mm],and there was no statistically significant difference between the two groups (t=0.09,P=0.54).The incidence rates of complication in A and B groups were 48.39% and 21.62%,respectively,and the difference between two groups was significant (χ2 =5.44,P=0.02).Conclusion The two treatments had significant and equal clinical effects,while because of its lower incidence rate of complication,the method ofperipheral iridectomy+trabeculectomy combined with cataract with phacoemulsification+intraocular lens implantationis more safe than the other one.

OBJECTIVE: To illustrate the Canadian drug regulatory system.METHODS: Literature review and descriptive analysis.RESULTS & CONCLUSIONS: Based on the Canadian health system and drug market,the Canadian drug regulatory system is an integrated system in terms of its regulation on drug approval,price review as well as reimbursement management.