ADVANCE trial demonstrated that stable intensive glucose control could improve prognosis and the target HbA1c should be 6.5%.While ACCORD and VADT trials suggested aggressive glucose lowering in diabetics at high cardiovascular risk is potentially harmful,tight glucose control yields no significant effect on long duration,poorly controlled patients with complications.DCCT and UKPDS research confirmed benefits of early intensive glucose control could persist due to legacy effect.Steno-2 research showed patients benefit greatly from comprehensive control of risk factors.In sum,early intensive control of risk factors and individualized treatment in diabetics are mainstream therapy.

Objective To observe the effect of neuromuscular electric stimulation (NMES) on post-stroke dysphagia (PSD). Methods Two hundred patients with swallowing dysfunction after stroke were randomly divided into a control group with 67 cases and a study group with 133 cases. All patients received pharmacotherapy and swal-lowing training. The study group also received NMES. The study group was sub-divided into unilateral and bilateral cortical stroke sub-groups, an ischemic stroke sub-group and a hemorrhagic stroke sub-group. The swallowing levels of the groups were compared after 2 courses of treatment with NMES. Results After an average of 20 days of NMES treatment, the level of dysphagia and its severity improved significantly. The patients with dysphagia due to unilateral stroke improved, on average, more than those with bilateral stroke. Patients with dysphagia due to ischemic stroke improved more than those with hemorrhagic stroke. Conclusions NMES therapy combined with rehabilitation train-ing can significantly improve swallowing in patients with PSD.

Objective To investigate the expression of matrix metalloproteinase-8 (MMP-8) in human breast cancers and its relationship with the clinicopathological parameters,evaluate the relevance of MMP-8 levels to metastases in breast cancer.Methods Human specimens were obtained from 50 patients with invasive ductal carcinomas,and 20 normal breast glands were enrolled.Intact clinical parameters were aviliable for all patients.The protein expression of MMP-8 was determined by immunohistocbemistry technology SP.Results The rate of MMP-8 positive breast cancer was significantly higher than that in normal breast glands [68 ％ (34/50) vs 15 ％ (3/20),P ＜ 0.05].The expression of MMP-8 showed a negative correlation with breast cancer staging.The expression of MMP-8 in stage Ⅰ was higher than that in stage Ⅱ and Ⅲ/Ⅳ[94 ％ (15/16),57 ％ (13/23),55 ％ (6/11),P ＜ 0.05].Lymph node negative patients had a higher MMP-8 expression than patients with lymph node metastases [84 ％ (21/25) vs 50 ％ (13/25),P ＜ 0.05].Conclusion MMP-8 expression is associated with human breast cancer metastases and might be involved in inhibiting metastases.

Objective To analyze the risk factors of intracranial infection after neurosurgery and the effect of vancomycin.Methods 28 cases of craniotomy in this study, The First Hospital of Ningbo City from January 2011 to July 2014 during the years after the occurrence of intracranial infection patients as the research object, a retrospective analysis of the age, gender, emergency, basic diseases, mastoid airroom, ventricle drainage, posterior fossa surgery, reoperation and operation time (more than 4h).The clinical data, summarize the risk factors of postoperative intracranial infection in department of neurosurgery and to observe the clinical effect of vancomycin in the treatment of such patients.Result The high risk factors of intracranial infection include: Open mastoid gas room during operation, ireoperation, ventricular drainage and operative time (more than 4h).In 28 cases with intracranial infection after craniotomy, the total effective rate of vancomycin treatment was 100.00%.Conclusion The high risk factors of intracranial infection after operation include open surgery, mastoid room, reoperation, ventricular drainage and longer operation time.Vancomycin is an effective drug in the treatment of intracranial infection in the department of neurosurgery.

Objective To prepare icariin-loaded poly(lactic-co-glycolic acid) (PLGA) nanoparticles (icariin nanoparticles) and analyze their physical and chemical properties,the release of icariin,and the effects on human osteoblast cells in vitro.Methods Icariin nanoparticles were prepared by ultrasonic emulsification and dialysis method and characterized by transmission electron microscopy and particle size analyzer.The release studies in vitro were adopted to evaluate the release-control features.Thiazolyl blue tetrazolium bromide (MTT),alkaline phophatase activity assay,and calcium nodes dyeing were carried out to investigate the effects of icariin nanoparticles on the growth and differentiation of human osteoblast cells MG-63.Results The icariin nanoparticles had spherical shapes and uniform particle size,and the mean size of the nanoparticles was (185.8±5.6) nm.The icariin nanoparticles showed the best property of sustained release and biocompatibility.Meanwhile,the icariin nanoparticles had no effect on the growth of MG-63 ceils,but they promote the differentiation of osteoblast cells by a concentration-and time-dependent manner.Conclusions The icariin nanoparticles prepared by ultrasonic emulsification and dialysis method have a good effect on the differentiation of human osteoblast cells in vitro and are biocompatible.

As a stable marker to reflect the average level of blood glucose,HbA1c is very important in glycaemic control evaluation.However,more and more data from evidence based medicine demonstrated that blood glucose fluctuation can also contribute to diabetic complication and prognosis which can not be neglected.Multiple capillary glucose measurements and continuous glucose monitoring are major methods to detect glucose fluctuation.Apart from insulin,various oral anti-diabetic drugs can reduce postprandial glucose excursion.Representative drugs include ?-glycosidase inhibitors,glinides and short-acting sulfonylureas,each have their own way of acting. Abstract:Summ ary:As a stab le m arker to reflect the average level of b lood glucose,HbA1c is very important in glycaem ic control evaluation.However,more and more data from evidence based m ed ic ine demonstrated that b lood glucose fluctuation can also contribute to d iabetic comp lication and prognosis wh ich can not be neglected.Mu ltip le cap illary glucose m easurem ents and continuous glucose mon itoring are m ajorm ethods to detect glucose fluctuation.Apart from insu lin,various oral anti-d iabetic drugs can reduce postprand ial glucose excursion.Representative drugs inc lude?-glycosidase inh ib itors,glin ides and short-acting su lfonylureas,each have the ir own way of acting.

Objective:To investigate the clinical characteristics, treatment, and evaluation of the prognosis of syndrome of inap-propriate anti-diuretic hormone (SIADH) in lung-cancer patients. Methods:We review the clinical data of six lung cancer cases, includ-ing four small cell lung cancer, one adenocarcinoma, and one squamous cell carcinoma, with SIADH complication. All six cases were treated in our hospital over the past three years. Results:Patients with various serum sodium levels were provided different therapeutic regimens. Symptoms of fatigue and nervous system disorders, plasma sodium, urine sodium, and plasma osmotic pressure were alleviat-ed. Conclusion:SIADH is a common complication of lung cancer, particularly in small lung cancer cases. Electrolyte disturbances indi-cate poor prognosis, high mortality rate, and delay in treatment because of clinical interest. After a final diagnosis has been made and ap-propriate treatment has been administered, clinical symptoms were relieved and blood sodium levels were quickly and significantly im-proved in these patients.

Objective To study the clinical value of the combination detection of serum tumor markers alpha fetal protein hetero-geneity-L3(AFP-L3) ,Golgi protein 73(GP73) and phosphatidylinositol proteoglycan-3(GPC-3) in the diagnosis of primary hepatic cancer .Methods The serum AFP-L3 ,GP73 and GPC-3 levels were measured in 34 patients with primary hepatic cancer (PHC) ,20 patients with liver cirrhosis ,20 patients with chronic hepatitis B ,37 patients with other tumors by the enzyme linked immunosor-bent assay(ELISA) .Meanwhile ,20 individuals with healthy physical examination were selected as the control group .The expression situation of various indexes were compared and analyzed .Results The expression levels of AFP-L3 ,GP73 and GPC-3 in the PHC group were significantly higher than those in the control group and the other tumors groups ,difference was statistically significant (P<0 .05) .The areas under the receiver operating characteristic (ROC) curve of PHC in the single item detection of 3 markers were 0 .909 ,0 .832 and 0 .817 respectively .The areas of the ROC curve in the combination examinations of two items were 0 .935 , 0 .945 and 0 .912 respectively .The area of the ROC curve in the 3-item combined detection of PHC could be up to 0 .960 .Conclusion The combined detection of AFP-L3 ,GP73 and GPC-3 can increase the detective rate of PHC and has important clinical significance to early diagnosis of PHC .

The significance of identification of mild cognitive impairment (MCI) is to intervene as soon as possible and delay or even prevent its progression to dementia.However,due to the limitations of diagnostic methods and standards,the diagnosis of in patients with MCI is more difficult.In recent years,as an emerging functional neuroimaging technique,resting-state functional magnetic resonance imaging (rsfMRI) has developed rapidly.It has been widely used in the studies of MCI.It may be provide objective biomarkers for the diagnosis of MCI.This article reviews the advances in research on rs-fMRI in MCI.

Objective To investigate the clinical efficacy of fire needling plus moxibustion in treating prurigo nodularis. Methods Ninety patients with prurigo nodularis were randomly allocated to treatment and control groups, 45 cases. The treatment group received fire needling plus moxibustion and the control group, external application of halometasone ointment. Skin lesions and pruritus were scored in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups. Results There were statistically significant pre-/post-treatment differences in the skin lesion score and the pruritus score in the two groups (P<0.01,P<0.05). There were statistically significant post-treatment differences in the skin lesion score and the pruritus score between the treatment and control groups (P<0.01). The total efficacy rate was 81.8% in the treatment group and 60.5% in the control group; there was a statistically significant difference between the two groups (P<0.05).Conclusion Fire needling plus moxibustion is an effective way to treat prurigo nodularis.