Several key issues in the diagnosis of osteoporosis were discussed. The definition of osteoporosis and some concepts in bone fracture risk evaluation were explained, so as the methods to avoid the common misunderstandings in clinical practice. Finally, the parameters used in determination of bone metabolism and bone mass were listed, and their application and limitation were analyzed. It may help the clinicians to make correct choice of these parameters.

Objective　To develop the newborn screening and treatment for congenital hypothyroidism (CH) in order to prevent the children from growth and mental retardation and to improve the population quality in China. Methods　TSH value in the dried-blood spot speciments on the filter papter was measured by time-resolved fluorescence immunoassay (Tr-FIA). Clinical analysis for the CH patients was performed. Results　Among 315　　472 neonates screened for CH, 66 (47 overt and 19 subclinical) cases of CH were confirmed and the incidence of CH was 1/4　　780. Among the 47 typical cases, 2 infants were recognized with transient hypothyroidism, 2 infants were not reevaluated because of below 2 year old, 1 infant died, 1 case gave up treatment, the rest 41 infants were permanent CH. Among the 19 atypical cases, 7 cases were recognized with permanent CH, 4 cases with transient disease, 5 cases with hyperthyrotropinemia, 3 cases were not evaluated because of below 2 years old at that time. The patients followed in the clinic are all currently with normal growth and intellectual development. Conclusion　Our center is the first labolatory to screen CH with Tr-FIA in China. Tr-FIA is an ideal non-radioactive technology. The typical patients as well as atypical cases should be all treated using L-thyroxine. It is essential to arrange a trial treatment for confirming the diagnostic results from screening and to decide whether they need a lifetime treatment.

Objective　To determine serum true insulin (TI) and proinsulin (PI) levels in patients with coronary heart disease (CHD), and to explore the relationships of them to other cardiovascular risk factors. Methods　Highly specific ELISA assays for TI and PI and RIA for immunoreactive insulin (IRI) were used. The fasting serum IRI, TI, PI levels in 30 nondiabetic patients with CHD and 30 healthy, age-matched control subjects were investigated. And the fasting and 2h postprandial plasma glucose, serum lipids and blood pressure were also determined in each individuals. Results　The levels of serum IRI, TI and PI were significantly higher in patients with CHD than those in controls (P＜0.05), while the value of insulin sensitivity index (ISI) was lower in patients with CHD than in controls (P＜0.05). There were significant independent correlations between TI, PI and age, BMI, plasma glucose, serum lipids. Conclusion Nondiabetic patients with CHD have hyperinsulinemia and insulin resistance and there is an independent association between proinsulin and dyslipidemia.

Recent studies have shown that pituitary hormones, including thyroid stimulating hormone (TSH), follicle stimulating hormone(FSH), adrenocorticotropic hormone(ACTH), and oxytocin(OT)may actually bypass their target endocrine organs and affect the skeleton directly. Therefore, a new conception, pituitary-bone axis is proposed. This breakthrough sheds a new light on the function of pituitary hormones and the pathogenesis of osteoporosis associated with hyperthyroidism, menopause or pregnancy, and even osteonecrosis after using glucocorticoids. In addition, it is conducive to give the reference guidance for clinical treatment of metabolic bone diseases and new drug development.

Objective　To explore the prophylactic effect of T cell vaccination (TCV) on type 1 diabetes. Methods　6-week-old nondiabetic femele NOD mice were vaccinated intraperitoneally with the attenuated, activated T lymphocytes isolated from the spleen of 4-week-old nondiabetic NOD mice, 18-week-old newly diabetic NOD mice and 32-week-old long-term diabetic NOD mice. The incidence of cyclophosphamide-treated diabetes, inflammatory score of insulitis in NOD mice as well as T lymphocyte subset changes in spleen and thymus were determined after TCV. Results　TCV was able to reduce the incidence of cyclophosphamide-treated diabetes, to alleviate insulitis, to increase the percentage of CD8+ T lymphocyte subset in spleen and CD4- CD8+ simple-positive T lymphocyte in thymus, and to decrease the percentage of IL-2R+ T lymphocyte and CD4+/CD8+ rate in spleen. Conclusion　TCV may decrease host autoimmunity, which seems related to the changes of T lymphocyte subsets in spleen and thymus and prophylactic effect on diabetes.

Objective　To examine the expressions of estrogen receptor α (ERα), estrogen receptor β (ERβ) and pituitary-specific truncated estrogen receptor product-1 (TERP-1) in diethylstilbestrol (DES) induced prolactinoma of rats. Methods　Ovariectomised Wistar rats were subcutaneously implanted with an implant containing 20 mg DES. Rats were implanted with a blank implant as controls. Eight weeks later, serum prolactin level of rats was measured by RIA. Prolactin immunoreactive cells of anterior pituitary were detected by immunohistochemistry assay. ERα, ERβ and TERP-1 mRNAs in pituitaries were examined by RT-PCR. Results　Serum prolactin levels, pituitary weights and pituitary prolactin immunoreactive cell countings in experimental group rats were all obviously higher than those in control group (P＜0.001 respectively). ERα, ERβ and TERP-1 mRNAs were all transcripted in DES induced rat prolactinomas. ERα and TERP-1 mRNA levels were significantly higher in experimental group than those in control group (P＜0.001 and P＜0.05). Conclusion　Estrogen plays a direct role in regulating pituitary prolactin cells through estrogen receptors. Further functional studies will be required to determine whether coexpression of ER variants along with normal ER confers a pathophysiological role in pituitary hormone regulation and (or) tumor cell proliferation.

Safety and tolerability of anti-diabetic drugs should be among the most concern when it comes to management of Type 2 Diabetes.With the understanding of functions of incretin and degrading enzyme dipeptidepeptidase (DPP-4),several DPP-4 inhibitors with different chemical structures are now available.They are welltolerated with few weight gain,hypoglycemia or adverse effects.Therefore,DPP-4 inhibitors are considered to be among the ideal anti-hyperglycemic agents.

With the progress of type 2 diabetes,there are more challenges for treatment.Traditional medications may not meet type 2 diabetes complicated clinical needs.Glucagon like peptide-1 ( GLP-1 ) has multiple physiological effects.Studies show that the liraglutide as the native GLP-1 analogue provides well glucose control in different stages of type 2 diabetes treatment,as well as β cell protection,body weight decrease and the prevalence of prediabetes reduction.Early usage of liraglutide especially suggests significant benefits,which will be summarized below.

Glucagon-like peptide-1 (GLP-1) is an ineretin hormone released from intestinal L-cells into circulation in response to dietary nutrient intake.Based on the recently finished studies,we reviewed the impact of GLP-1 on gastric emptying,satiety,and food intake.Meanwhile,the ehnical advantage and gastrointestinal adverse effects of long-acting GLP-1 analogue liraglutide were evaluated.

Glucagon-like poptide-1 (GLP-1) is an incretin secreted by the enteroendocrine L cells of the gut. Upon the activation of GLP-1 receptor, adenylyl cyclase is activated and cAMP is generated, leading to the activation of protein kinase A and Epac signal pathway. GLP-1 could also activate calcium/calmodulin pathway as well as mitogen-activated protein kinases and phosphatidyl inositol-3 kinase pathway. GLP-1 not only stimulates the phase 1 and phase 2 insulin secretion, but also increases insulin synthesis. GLP-1 also stimulates proliferation and differentiation of islet β-cells, and protects β-cell from apoptosis and modulates endoplasmic reticulum stress response leading to promotion of β-cell adaptation and survival.