Type 1 diabetes is pathologically characterized by autoimmune insulitis-related islet β-cell destruction.Although intensive insulin therapy for patients with type 1 diabetes can correct hyperglycemia,this therapy does not effectively prevent diabetes-related cardiovascular complications.Hence,preservation of natural β-cell function is critical for the prevention of diabetes-related complications.Receut studies have shown that autologous hematopoietic stem cell transplantation ( A HSCT) is a new promising approach for the treatment of type 1 diabetes by reeonstitution of immunotolerance and preservation of islet β-cell function.Here we introduce the key results of a clinical trial ( NCT 01341899,ClinicalTrials.gov) performed in Chinese type 1 diabetes patients ( most of them with diabetic ketoacidosis at onset ) and discuss the potential mechanisms underlying the action of HSCT and its prospects in the clinical management of type 1 diabetes.

The critical role of α- and β-cell dysfunction in the development of type 2 diabetes has been established.Dipeptidyl peptidase-4 (DPP-4) inhibitors are new class of oral anti-hyperglycemia agents that acts to increase active levels of the incretin hormone glucagon-like peptide-1 ( GLP-1 ) and glucose-dependent insulinotropic polypeptide ( GIP),which improved α- and β-cell function.This action is shown as improved α- and β-cell sensitivity to glucose,increased glucose-dependent insulin secretion and decreased glucagon secretion.DPP-4 inhibitors treatment has also been associated with beneficial extrapancreatic effects,including improved peripheral insulin sensitivity and lipid metabolism.Additionally,DPP-4 inhibitors have shown a minimal risk of hypoglycemia and bodyweight neutrality without effects on gastric emptying.Numerous clinical trials have verified the favorable efficacy,safety,and tolerability of DPP-4 inhibitors treatment in monotherapy or combination with other anti-diabetic agents for patients with type 2 diabetes.

Objective To investigate the clinical characteristics and classification of ketosis-prone diabetes. Methods Firstly,according to with or without autoantibodies,patients with an initial onset of unprovoked ketosis or ketoacidosis were classified to two different groups. Secondly,based on weather or not depending on insulin,patients without autoantibodies were further divided into two groups,insulin dependent and non-insulin dependent. Clinical characteristics,biochemical parameters were compared between different groups. Results The autoantibodies negative group showed a strong male predominance and family history of diabetes.BMI was higher than type 1 diabetes. Plasma triglyceride level was highest. Fasting and postprandial C-Peptide level was between the other two group. Compared with non-insulin dependent group,insulin dependent group showed a strong male predominance,lower ratio of overweight and obesity,more severe ketosis status. There were no significant differences with regard to blood glucose level and fasting C-Peptide level of initial. But fasting C-Peptide after 3 months was higher in non-insulin dependent group . Conclusion Ketosis-prone diabetes can divided into two groups,based on autoantibody negative or positive. The latter consist of type 1A diabetes mellitus. The former can further classified as ketosis-prone type 2 diabetes and idiopathic type 1 diabetes(type 1B diabetes)according to insulin dependent or non-insulin dependent.

Objective To express human chemokine-like factor 1 (CKLF1) in Drosophila S2 cells and study its function. Methods The pMT/V5-His-CKLF1 expression plasmid was constructed and transfected into Drosophila S2 cells. The positive clones were selected through PCR and RT-PCR. The culture medium was analyzed by Western blot with anti-CKLF1 polyclonal antibody. Chemotaxis and MTT assays on human peripheral blood and C2C12 cells, respectively, were then carried out with the medium. Results CKLF1 was transcribed efficiently in S2 cells. The expressed CKLF1 protein could be detected in the culture supernatant by Western blot, which showed weak chemotactic activity on both human peripheral blood neutrophils and lymphocytes as well as enhancing effect on the proliferation of C2C12 cells. Conclusion CKLF1 was expressed successfully in Drosophila S2 cells and secreted into the culture medium. The recombinant CKLF1 expressed in Drosophila cells can chemoattract leucocytes and promote the proliferation of C2C12 cells.

Objective With the development of minimally invasion and the popularization of arthroscopy the technology of ar-throscopy has been widely applied for the treatment of acute and the safety of this has been validated.To analyze the clinical effect of ar-throscopically assisted double Endobutton plate reconstruction of coracoclavicular ligament in the treatment of acute acromioclavicular joint dislocation. Methods From November 2013 to December 2014, a total of 23 patients with Rockwood type III,Ⅳ,Ⅴshoulder joint dis-location were included, all cases was treated by arthroscopic double Endobutton fixaton technique.Patients were followed up for 6 to 18 months.The changes of shoulder joint forward elevation and external rotation, Japanese Orthopaedic Association score(JOA), and Visual Analogue score( VAS) of acromioclavicular joint in both perioperative and postoperative were recorded. Results The mean follow-up time was (9.3 ±2.4) months ( range from 6 to 18 months),and mean time from injury to surgery was(10.1 ±3.2)days.The therapeutic effects were achieved in all patients after the arthroscopically assisted double Endobutton plate reconstruction.All the measurements, in-cluding the mean forward elevation JOA scores before and after fixation (71.0 ±5.4 vs 93.5 ±3.6), and mean VAS scores (4.6 ±1.0 vs 1.9 ±0.9), mean forward elevation [(102.5 ±8.6) degrees vs (144.3 ±6.3) degrees], and mean external rotation[(107.1 ±6.2) de-grees vs (149.6 ±7.5) degrees] improved significantly (P<0.05) after the treatment. Conclusion Arthroscopic double Endobutton fixaton technique could provide an effective immobilization of shoulder and acromioclavicular joint, thus improving the function of the joint and achieving an excellent effect in the treatment of acute acromiocla-vicular joint dislocation.

This study was aimed to establish the three-dimensional model of C_(3-7) segment of lower cervical spine after artificial disc implantation, to analyze the movement of lower cervical spine after artificial disc replacement. According to CT films of 1 patient at 6 months after artificial disc implantation, three-dimensional finite element model that included Bryan~(TM) artificial cervical disc prosthesis of the lower cervical spine was established using finite element method, then introduced into Ansys 9.0, the vertebral cortical bone, cancellous bone and intervertebral disc were meshed and analyzed by using under several states such as flexion/extension, lateral bending and rotation, thus understanding their motion characteristics. By comparison with previous research findings, test results nearly accorded with or exhibited identical trend with previous study. The results suggest that, cervical disc replacement can basically guarantee the stability of lower cervical spine movement.

Objective To determine the expression and distribution of Disabled-2(Dab2) in normal human adrenal glands, and further to study the expression of Dab2 in tissues of different adrenocortical adenomas, and to elucidate whether Dab2 can be a specific molecular marker in the pathology of primary aldosteronism. Methods Real-time PCR and immunohistochemical staining were used to detect Dab2 expression in 10 aldosterone-producing adenoma (APA) samples, 8 cortisol-producing adenoma ( CPA) samples, 8 non-functioning adenoma ( NFA) samples and 6 normal adrenal samples. Results Immunohistochemical staining showed that Dab2 was significantly highly expressed in zona glomerulosa of normal human adrenal glands. Sporadical cluster of ZG cells with moderate Dab2 staining were demonstrated in APAs. In all CPA and NFA tumors, weak dab2 staining was detected. According to the results of real-time PCR, Dab2 mRNA expression was increased significantly in APAs compared with normal adrenal glands. There was no significant difference between normal adrenal glands, CPAs, and NFAs in regard to Dab2 mRNA expression. Compared to nontumor portions, APAs also showed higher Dab2 mRNA expression in the tumor( P<0. 05). Conclusion Dab2 was predominantly localized in zona glomerulosa in normal adrenal gland. Increased Dab2 mRNA expression was detected in APAs compared with normal adrenal glands. Whereas, Dab2 protein expression was just moderate increased in APAs. Weather Dab2 can be a specific molecular marker in the pathology of primary aldosteronism has to be further studied.

Objective To investigate the clinical and pathological characteristics of normotensive pheochromocytomas ( NP) . Methods This retrospective study included 97 patients with a pathological diagnosis of pheochromocytoma at the Drum Tower Hospital Affiliated to Nanjing University Medical School during January 2004 to December 2013. All available clinical, biochemical, and radiological records were reviewed in these patients who were then categorized into hypertensive pheochromocytomas (HP) (n=64) and NP (n=33) groups. 97 cases of Adrenal Gland Scale Score of pheochromocytoma were examined, including tissue microscopic pathology assessment, ki67 and phenylethanolamine-N-methyltransferase ( PNMT ) immunohistochemistry and catecholamine type. Biochemical examinations of 95 subjects with primary hypertension ( PH) were recorded for comparative study. Results The patients with NP showed lower proportion of clinical triad than HP, inapparent metabolic disorders, and lower urinary catecholamine levels than HP, but showed higher results than primary hypertension. The weight of tumor was positively correlated with 24 hour urinary norepinephrine level in patients with HP(Y=1. 376+0. 653X,R2=0. 118, P=0. 028), but not in patients with NP;and the size or diameter of the tumor was negatively correlated with PNMT immunohistochemistry in patients with NP(Y=0. 940-0. 356X, R2=0. 494, P=0. 005), but not in patients with HP, indicating that NP may be misdiagnosed clinically. Conclusion Patients with NP have distinct clinical, biochemical, and pathological phenotypes; the phenotypic changes are closely related with the expression levels of catecholamine pathway products during the occurrence and development of the tumors.

The paper briefed characteristics of emergency medical centers in developed countries, described the current status in China, and analyzed problems found in the emergency medical rescue system in the country.On such basis, the authors proposed on the organization, network building, communication and information system, rescue teams, rescue equipments, synergy mechanism, and assurance measures, for the purposes of capacity building and resue capacity of the pre-hospital care institutions in China.

Objective:The application of computer-rapid prototyping-assisted simulated hollow screw in the treatment of femoral neck fractures in fresh cadavers verified the reliability and accuracy of computer-rapid prototyping-assisted simulated hollow screw in the treatment of femoral neck fractures.Methods:The glass ion was labeled as a target for the treatment of femoral neck fracture with a cannulated screw. Three Kirschner pins were placed at the top and bottom of the greater trochanter. CT scan of the processed specimens. The scan data was imported into Mimics software, and the upper end of the femur was reconstructed three-dimensionally and the target of the femoral neck fracture was fixed with cannulated screws. The position of the cannulated screw in the femoral neck was designed. In Pro/E software, draw a guide that fits the three positioning Kirschner pins and cannulated screw guide needles on the upper end of the femur, and use rapid prototyping technology to make the guide. The navigation template was mounted on the positioning pin through the cannulated screw guiding hole, and the hollow screw guiding needle was drilled, and the hollow screw was inserted for the treatment of the femoral neck fracture to complete the positioning and guiding. According to the coordinates of the hollow screw guide needle and the target center in the Mimics software three-dimensional reconstruction coordinate system, the spatial distance calculation formula is used to calculate the distance between the hollow screw guide needle and the target center.Results:The coordinate analysis of the end point of the cannulated screw guide needle and the target can be obtained that the average distance between the end point of the cannulated screw guide needle for fixed femoral neck fracture and the target center point was 1.92 mm.Conclusion:The computer-rapid molding-assisted cannulated screw fixation of the femoral neck fracture is reliable and accurate, which provides a new idea and method for clinical individualization and precise fixation of the femoral neck fracture.