This study was to evaluate the risk factors of nocturnal hypoglycemia in elderly patients with type 2 diabetes by continuous glucose monitoring system. Fifty-one type 2 diabetic patients aged 60 or above were enrolled and the episodes of nocturnal hypoglycemia were documented. The risk factors of nocturnal hypoglycemia were analyzed by logistic regression and the cut-off of glucose levels at bedtime for nocturnal hypoglycemia was evaluated. There were twenty-two patients with total 681 nocturnal hypoglycemic episodes. Logistic regression analysis showed that the lowest glucose level at bedtime was the risk factor of nocturnal hypoglycemia (OR=0.36, 95% CI:0.13-1.00, P<0.05), while the gender, age, diabetes duration, therapy regimen, the highest and average glucose levels at bedtime were not associated to nocturnal hypoglycemia. Receiver operating characteristic curve (ROC) showed that the bedtime glucose at≤6.2 mmol/L was the best cut-off point for predicting nocturnal hypoglycemia.

Objective To study the effect of calorie restriction at early age of rats on their islet β cell mass in adulthood.Methods Sixteen 8-week-old male SD rats were randomized to control group (n=7) and calorie restricted group (n =9).The rats in control group took food freely,while the ones in calorie restricted group were given 70％ calorie of the control group.After 24 week calorie restriction,cholesterol (TC),triglyceride (TG),high density lipoprotein-cholesterol (HDL-C) and low density lipoprotein-cholesterol (LDL-C) were tested.The β cell mass was measured by immunohistochefistry and the activity of superoxide dismutase (SOD) as well as the level of malondialdehyde (MDA) in pancreas homogenate were determined by ELISA.Results The increase of the body weights(45 g vs.184 g)and the level of TG [(0.61±0.15)mmol/L vs.(0.78±0.14)mmol/ L]of the rats in the calorie restricted group were lower than those of the control group (P＜0.05),while the β cell mass [(43.6±9.8)mg vs.(31.9± 11.6)mg],β cell mass of every milligram pancreas tissue[(89.7 ± 7.4) μg/mg vs.(44.8g ± 14.1) μg/mg] and β cell mass per body weight[(11.5±2.5) × 10-5 vs.(6.3 ±2.3) × 10-5]of the rats in the calorie restricted group were higher than those of the control group (P＜0.05).There were no differences in the SOD activity [(0.91±0.30)nmol/ mg protein vs.(0.68±0.14)nmol/ mg protein]and MDA level [4.97± 0.65)U /mg protein vs.(6.05 ±2.14)U/mg protein] in pancreas homogenate between the two groups (P＞0.05).Conclusions Calorie restriction at early age of rats may increase the islet β cell mass in their adulthood.

Eleven-week-old SD rats were randomized into control and calorie restriction group. The pancreatic β cell function and oxidative stress indexes in the two groups were compared after 24-week intervention. The results showed that calorie restriction, which started from young age, improved the early insulin secretion after glucose loading and alleviated the oxidative stress in adult rats, which wag related to the reduction of body weight.

Primary Sj?gren′s syndrome ( pSS) is a kind of chronic autoimmune disease affecting many organs of the body. The pathogenesis of pSS is still debated. Epstein-Barr virus(EBV), also called human herpesvirus-4, belongs to the herpesviridae family. Researchers have found that EBV is associated with pSS. With the deepening of researches, more evidences and opinions about the participation of EBV in the pathogenesis of pSS have emerged. EBV can cause the development of pSS in multiple ways. In this re-view, we summarize the roles of EBV in the pathogenesis of pSS.

Objective To study the effect of interleukin 2(IL-2)of clinical dose range,on the proliferation of human peripheral blood T cells,with special emphasis on the number and functional phenotype of γδT cells.Methods Human peripheral blood mononuelear cells(PBMCs)were isolated by density gradient centrifugation and cultured for 2 weeks at different IL-2 concentrations.Ratio and phenotype of different T cell subpopulations before and after in vitro expansion were explored by immunofluorescence staining.Cell number was estimated by trypan blue staining and cell counting.Results Within the four functional phenotypes of Vδ1 as well as Vδ2 γδT cells,CD27~+cells(including CD27~+CD45RA~+and CD27~+CD45RA~-subsets)expressed lymphoid tissue homing receptor CCR7,whereas CD27~-cells(including CD27~-CD45RA~+and CD27~-CD45RA~-subsets)had the peripheral tissue homing potential.All the studied γδT functional subsets showed the expression of activity related receptors,and the ability of a rapid production of various amount of cytotoxicity related effectors following mitogen stimulation.Although IL-2 at high concentration suppressed the proliferation of CD4 T cells,it may promote the proliferation of γδT cells.The proliferated γδT cells were mainly CD27~-CD45RA~-effector cells.Conclusion IL-2 of the clinical dose range may promote proliferation of human peripheral blood γδT cells,which might have important biological significance in IL-2 based anti-tumor therapy.

Objective To establish an expression system of TCRγ9/δ2-Fc protein by baculovirus vector ex-pression system and identify biological function of expressed TCRγ9/δ2-Fc protein. Methods γ9Fc and 82 (OT3) Fc gene fragments were amplified by overlap PCR and inserted into expression vector pBACp10ph. The recombinant plasmid pBACp10ph-γ9/δ2(OT3)-Fc and the baculovirus DNA were co-transfected into st9 cells. The expression position of TCRγ9/δ2 (OT3)-Fc was identified by Western blot and the expression efficiency of γ9Fc and δ2 (OT3) Fc was tested by flow cytometry (FCM). Furthermore, the binding activity of TCRγ9/δ2 (OT3)-Fc protein with SKOV3 ceils and MNS protein was evaluated with laser scanning confocal microslopy and surface plasmon resonance (SPR). Results The recombinant vector pBACp10ph-γ9/δ2(OT3)-Fc was constructed and TCRγ9/δ2(OT3)-Fc protein was expressed in sf9 ceils. However, the expression efficiency of γ9Fc and 82 (0T3) Fc was quite differ-ent. It was proved that purified TCRγ9/δ2 (OT3)-Fc protein can bind with SKOV3 cell and MNS protein. Conclu-sion TCRγ9/δ2-Fc protein is successfully expressed in baculovirus vector expression system and TCRγ9/δ2-Fc protein can simulate the binding activity of TCR in vitro.

Objective To investigate the epidemiological characteristics of mycoplasma pneumoniae (MP),Epstein-Barr virus (EB virus) and cytomegalovirus (CMV) infection in children with acute upper respiratory tract infections in Hangzhou.Methods Throat swabs and sputum samples were collected from 5942 children with acute upper respiratory tract infections in Hangzhou First People's Hospital during January 2011 and December 2012.MP,EB virus and CMV were detected using quantitative PCR.The distribution and seasonal changes of the above pathogens in children of different ages were analyzed using Chi-square tests.Results MP,EB virus and CMV were positive in 29.91％ (1777/5942),22.92％ (1362/5942) and 8.55％ (508/5942) children,respectively.Mixed infections were found in 556 (9.36％) children.The positive rates of MP varied among different age groups (x2 =113,P =0.000),and the highest one was detected in children ＞ 6-year old (448/1012,44.36％).EB virus infection was rare in age group 0-1 year,and the positive rate was of statistical difference from those in other age groups (x2 =167,181 and 187,P =0.000).The highest positive rate of CMV (23.78％) was found in children aged 0-1 year old.The positive rates of MP varied in different months of the year (x2 =208 and 211,P =0.000),and the highest positive rate was found in July and August.Conclusion The predominant pathogen of acute upper respiratory tract infection in children is MP in Hangzhou,and MP plus EB virus infection is common,particularly in older children;while CMV infection more likely occures in 0-1 year old babies,and usually in summer.

Objective To investigate in knowledge rate of 120 first aid and satisfaction rate with emergency services among Nanchong citizens. Methods 360 patients who received prehospital first aid from three hospitals and their accompanies were selected from January to June 2010. The investigation content included knowledge rate of 120 first aid and satisfaction rate with emergency services. Results Results showed that about half of those surveyed still did not know the emergency phone"120" and its function, lacked self-help and self-protection knowledge, some respondents felt quite helpless upon daily life of electric shock, gas poisoning, coma and traumatic accidents. The attitude of the majority of emergency personnel was good or better, but still very stiff or irresponsible attitude existed in those few. This undermined the "120" and the image of credibility and emergency personnel. Conclusions There is an urgent need for universal coverage of on-site first aid knowledge and enhance awareness of first aid. Full-time staff in emergency department must pay close attention to the knowledge of first aid training, mastering the technique of bleeding control and bandaging, fixing, handling and CPR, as well as the use of instruments and equipment equipped in vehicles. Only in this way can we continuously improve the treatment of critically ill patients and increase survival rate.

AIM:To investigate the effects of brain-derived neurotrophic factor(BDNF)on extracellular proteolytic enzymes including matrix metalloproteinases(MMPs)and serine proteases,in particular,the urokinase-type plasminogen activator(uPA)-plasmin system in a human umbilical vein endothelial cell(HUVEC)model.METHODS:The HUVEC was activated with different doses of BDNF(25-200 ?g/L)for different time period(6-48 h).Reverse transcriptase-polymerase chain reaction(RT-PCR)was used to assay MMP-2,MMP-9,TIMP-1,and TIMP-2 mRNA in HUVEC.The cultured conditioned medium was analyzed for MMP and uPA activity by gelatin zymography and fibrin zymography,respectively.uPA,PAI-1,TIMP-1,and TIMP-2 were quantified by Western blotting analysis.RESULTS:The stimulation of serum-starved HUVECs with BDNF caused marked increase in MMP-2 and MMP-9 mRNA expression and induced the pro-MMP-2 and pro-MMP-9 activation without significant differences in proliferation.However,BDNF had no effect on TIMP-1 and TIMP-2 production.BDNF increased uPA and PAI-1 production in a dose dependent manner up to 100 ?g/L,while effects of 200 ?g/L were approximately equal to those of 100 ?g/L.BDNF stimulated uPA and PAI-1 production beyond that in control cultures from 12 h until 48 h after BDNF addition.Protease activity for uPA was also increased by BDNF in a dose dependent manner.CONCLUSION:BDNF activates MMP and uPA/PAI-1 proteolytic network in HUVEC.

Objective:To investigate the prevalence of fever after intravenous injection of for the first time in osteoporotic patients who have or haven’t taken bisphosphonates orally.Methods:Bone mineral density measurement was conducted of the osteoporotic patients using dual-energy X-ray absorptiometry method,and according to the WHO diagnostic criteria for osteoporosis,the patient whose T score was less than -2.5 was defined as osteoporosis.The data of 113 osteoporotic patients who received intravenous injection of zoledronic acid in our hospital for the first time were used for analysis.Among them,35 who had the history of oral bisphosphonates were defined as group A,and 78 who didn’t have the history of oral bisphosphonates were defined as group B (control group).Moreover,we also compared the preva-lences of fever between the patients.Pearson chi-square test was used to investigate the association be-tween oral bisphosphonates therapy and prevalence of fever,and binary logistic regression was used to an-alyze the impact factors of fever after intravenous injection of zoledronic acid.Results:Among the 35 pa-tients who had the history of oral bisphosphonates,nobody had high fever,and 2 patients had low or mo-derate degree of fever (5.71%).Among the 78 patients who didn’t have the history of oral bisphospho-nates,33 patients had fever (42.3%),15 with low fever,and 14 with moderate degree of fever,and 4 with high fever.Pearson chi-square test showed that the prevalence of fever between group A and group B had significant difference,and that differences of prevalence of fever between the outpatients and the inpa-tients was not statistically significant.Binary Logistic regression analysis showed that oral bisphosphonates medication history was a protective factor of fever,and with the increasing of previous oral bisphosphonates for one month,there was a reduction of fever for 23.1%.Conclusion:Patients who have the history of oral nitrogenous bisphosphonates alendronate have a significant reduction in prevalence of fever after intravenous injection of zoledronic acid for the first time.That is,oral nitrogenous bisphosphonates alendronate history is a protective factor of fever for patients with intravenous injection of zoledronic acid for the first time.