Objective To study the relationship between u rinary,serum laminin (LN) and urinary albumin (Alb) in type 2 diabetes mellitus.Methods Urinary,serum LN and urinary creatinine (Cr) were measure d in 116 patients with type 2 diabeties mellitus and 31 normal controls .Results ①Urinary LN/Cr in DM microalbumi nuria (DMMA) group was higher than control group (group C) (P

Objective To determine the serum level of Visfatin, and observe the effect of short-term treatment of rosiglitazone on it in the patients with type 2 diabetes mellitus. Methods Thirty-three patients with type 2 diahetes mellitus(diabetic group) who were inadequately controlled by suffonylureas were treated with rosiglitazone (4 mg/d) for 12 weeks. Twenty-seven sex-, age- and BMI-matehed non-diabetic subjects (control group) were studied. Determined blood pressure, Visfatin, triglyceride (TG), high density lipopro-tein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), fasting plasma glucose (FPG),2-hoar postprandial glucose (2 h PPG), fasting insulin (FINS)in all subjects and free fatty acid (FFA), high sensitive C-reactlve protein (hs-CRP) and glyeosylated hemoglobin (GHbA1c), abdominal fat distribution before and after treatment with rosiglitazone in diabetic group respectively. Results The level of serum Visfatin was lower in diabetic group than that in control group [(24.53±9.22) μg/L vs (53.10±27.00)μg/L, P<0.01 ], and it was higher after treatment with rosiglitazone for 12 weeks, but there was no significant difference [(24.53±9.22)μg/L vs (32.62±24.89) μg/L, P>0.05]. Visfatin was correlated significantly with systolic pressure (r =-0.29, P=0.02), FPG (r=-0.40, P=0.001 ), 2 h PPG (r=-0.34, P=0.009 ),LDL-C (r=0.26,P=0.049) and FFA (r=0.44,P=0.009) respectively. In a linear stepwise regression analysis, FFA showed significant correlation with serum Visfatin levels (r2=0.30,f=7.707, P=0.009).Conclusions The level of serum Visfatin is lower in type 2 diabetes mellitus, and it is related significantly with glucose and lipid metabolic factors. The short-term treatment with rosiglitazone can't increase the serum concentration of Visfatin in the type 2 diabetes mellitua.

AIM: To explore the effects of fluctuant high blood glucose and stable high blood glucose on apoptosis and the expression of Bax and Bcl-2 in glomerular endothelial cells and renal tubular epithelial cells in diabetic rats. METHODS: 24 SD rats were divided into 3 groups: control group, stable high blood glucose group and fluctuant high blood glucose group. Diabetic rats were induced by intraperitoneal injection of STZ, and the fluctuant high blood glucose animal model was induced by intraperitoneal injection of aspart and glucose at different time points every day. Apoptosis was assessed by terminal deoxynucleotidyl transferase-mediated dUTP nick-end labelling (TUNEL), and immunohistochemistry was used to detect apoptosis associated gene bax and bcl-2 expression in kidney. RESULTS: After 4 experimental weeks, a significant increase in cell apoptosis, up-regulation of Bax protein expression in kidney tubular epithelial cell and down-regulation of Bcl-2 in glomerular endothelial cell in fluctuant high blood glucose rats were observed compared with stable high blood glucose rats.CONCLUSION: Fluctuant high blood glucose induces more apoptosis in renal tubular epithelial cells than that in stable high blood glucose diabetic rats.

OBJECTIVE To explore the risk factors and preventive measures of nosocomial infection among the diabetes mellitus patients with cerebrovascular accident.METHODS A retrospective survey on 574 diabetes mellitus patients with cerebrovascular accident was conducted.RESULTS The result showed that 126 of the 574 patients had nosocomial infection,the rate of infection was 22%.The risk factors of nosocomial infection included: age,hospitalized days,invasive treatment procedures and operation,application of antibiotics,course of diabetes mellitus,fasting plasma glucose(FPG),glycosylated hemoglobinA1C(HbA1C),clinical type of cerebrovascular accident,consciousness and bulbar palsy. The main infection sites were at lungs,urinary tract and intestines.The chief pathogens were Gram-negative bacteria.CONCLUSIONS Nosocomial infection is a high frequent complication in diabetes mellitus with cerebrovascular accident.Preventing and controlling the risk factors can reduce the rate of nosocomial infection among the diabetes mellitus patients with cerebrovascular accident.

The rennin angiotensin system has been recognized for many years as a key regulator in systemic blood pressure and the metabolism of water and salt. Angiotensin converting enzyme 2(ACE2) is the first human homolog of angiotensin converting enzyme which efficiently hydrolyze the angiotensin Ⅱ to vasodilator angiotensin 1-7.ACE2 is now implicated in cardiovascular,renal, lung disease and serves as a receptor for Severe Acute Respiratory Syndrome coronavirus.

Objective To compare the operation effects of sensation restoration after tumor resection in the head and neck defects reconstruction by anterolateral thigh flap with or without sensory nerve transplantation.Methods The application of 76 cases anterolateral thigh flaps in head and neck defects reconstruction after tumor resection from May,2011 to May,2015 were observed.35 patients underwent simultaneous reconstruction with sensory nerve anastomosed perforator based anterolateral thigh flap and 41 patients underwent simultaneous reconstruction without sensory nerve graft based anterolateral thigh flap,which was named as group A and group B,respective ly.The treatment effectiveness of the two groups was compared and graded into First,Second and Third rate.Results All the 76 flaps survived.Satisfying morphology for the maxillofacial region and stage-one healing for the donor site was available.During the 24-week follow-up,group A were 65.71％ (First rate),28.57％ (Second rate),5.72％(Third rate) respectively,and the condition of group B were 31.70％,26.84％,41.46％.The treatment effectiveness of group A was better than that of group B.Postoperative complications were less than group B(P ＜ 0.05).Conclusion Compared with the loss of nerve transplantation of anterolateral thigh perforator flap,sensory nerve anastomosed perforator based anterolateral thigh flap is of great value to reconstruct the defect after resection of tumor in head and neck region and restore the sensation of flap.

Objective To investigate the effect of matrix metalloproteinas-9 (MMP-9) and high sensitive C-reactive protein (hs-CRP) in type 2 diabetes mellitus (T2DM) combined with coronary heart disease(CHD). Methods Thirty-one patients with T2DM combined with CHD(T2DM combined with CHD group) ,50 patients with CHD (CHD group) and 30 healthy volunteers (control group) were studied. Serum MMP-9 was measured by ELISA, and serum hs-CRP was measured by scattering immunoturbidimetric assay. Results The level of MMP-9 in T2DM combined with CHD group (409.62 μg/L) was significantly higher than that in CHD group (263.40 μg/L) and control group [(196.15 ±44.89) μg/L] (P < 0.05).The level of hs-CRP in T2DM combined with CHD group (17.20 mg/L) was significantly higher than that in CHD group (4.57 mg/L) and control group [(1.52±0.78) mg/L] (P <0.01). MMP-9 wa significantly related with hs-CRP in T2DM combined with C HD group (r = 0.482,P < 0.01). Conclusion The serum M MP-9 and hs-CRP levels are closely associated with the occurrence and development of diabetes related coronary atherosclerosis.

Objective To explore the effect of repaglinide intensive treatment on islet β-cell function and long-term control of blood glucose in newly diagnosed type 2 diabetic patients. Methods Self-control and inter-group control prospective study was conducted in 80 newly diagnosed type 2 diabetic patients who were treated with short-term repaglinide intensive treatment and islet β-cell function was assessed by 75 g oral glucose tolerance test (OGTT) before and after repaglinide treatment. The changes of △I30/△G30 ratio, blood lipid, HOMA A and HOMA B were examined. Results After treatment, in successful group, middle group and defeat group, the fasting plasma glucose levels were decreased from 8.9±1.5, 8.6±1.6,9.0±2.0 to 5.0±1.4,6.3±0. 7,6.5±0. 9 mmol/L, 0. 5 h postprandial glucose levels were decreased from (12.6±1.6, 12.6±1.5, 12.4±1.3 to 8.4±1.0, 6.8±0. 7, 8. 6±0. 9)mmol/L,and 2 h postprandial glucose levels were decreased from (13.0±1.2, 13. 1±1.3, 13. 3±1.4 to 9.2±0.9, 6.6±0. 7, 9.2±0. 9)mmol/L,respectively (all P <0. 005). The ratio of △I30/△G30 was increased froml. 69±0. 31, 1.72±0. 33, 1.79±0. 36 to 4. 47±0. 62, 4. 42±0.46,12. 00±0.46 in the three groups, respectively (P<0.05). HOMA B was significantly improved (P<0. 05), while triglycerides and HOMA A were decreased(P<0. 05). The levels of fasting blood glucose and postprandial blood glucose in 21 patients were maintained within normal range for more than six months. There were significant differences in the ratio of △I30/△G30, age, repaglinide dosage and the time of reaching target of glucose [4.47±0.62 vs. 2. 0± 0.46; 39±8 vs. 56±9; 2.0±1.5 vs. 5.0±2.5; 32.4±8.0 vs. 53.3±7.6; all P<0.05] between successful group and defeat group. Conclusions The short-term intensive treatment with repaglinide can significantly improve the early secretion phase of insulin and the islet β-cell function, reconstruct of the physiological model of insulin secretion and relieve the disease.

Urinary excretions of transforming grow th factor-? 1 (TGF-? 1), laminin (LN) and type Ⅳ collagen were determined i n 182 type 2 diabetic patients. Urinary excretions of TGF-? 1, LN and type Ⅳ collagen were increased in type 2 diabetic patients, and these findings were fa irly well correlated with severity of diabetic nephropathy (DN). Urinary TGF-? 1 seems to be the early index of DN, urinary LN and type Ⅳ collagen appear to be the indices of DN severity.

AIM: To investigate the effect of losartan on the mRNA expression of type 2 angiotensin II receptor and cytokines in diabetic rat kidney.METHODS: SD rats were randomly divided by following groups: control rats(group C),diabetic rats(group D) and diabetic rats treated with losartan (30(mg?kg~(-1)?d~(-1)),by gavage,group DT).At the end of 8-weeks study,mRNA expressions of the type 2 angiotensin II receptor(AT_2),transforming growth factor-?_1(TGF-?_1),platelet-derived growth factor-B(PDGF-B),tumor necrosis factor-?(TNF-?) and collagen Ⅳ in rats renal cortex were measured by RT-PCR,respectively.In addition,angiotensin Ⅱ level in renal cortex was determined by the radioimmunoassay.RESULTS: In group D,urine protein excretion(P