After the origin, definition and functions of core journal were described, scientifically understanding their value and accurately defining their functions were proposed.The current evaluation of military sciences core journals was analyzed with measures put forward for perfecting their evaluation systems.

Recently,basic and clinical researches have shown that blood glucose variability is an independent risk factor for diabetic complications.Thus,ideal control of blood glucose is not only to reach the HbA1Ctarget,but also to minimize blood glucose variability.Different glycemic parameters could be selectedaccording to different purpose of evaluation,in which the mean amplitude of glucose excursions(MAGE) and the standard deviation of blood glucose (SDBG) could be used as accurate and simple assessment parameters respectively.

Objective To investigate the blood glucose control level,the characteristics of complications and treatment programme in senile patients with type 2 diabetes.Methods From Aug 2010 to Jul 2011,gender,age,height,weight,disease course and underlying disease were recorded in 119 patients with type 2 diabetes aged 80 years and over.The levels of glycosylated hemoglobin (HbA1c),fasting C-peptide (FC-P) and 2 hours postprandial C-peptide (2h C-P),urinary albumin excretion rate (UAER) were tested.Ultrasonic Doppler examination of lower-limb arteries as well as non-mydriatic colour eye-ground photography were also examined,peripheral nerve lesions were evaluatcd according to the criteria of diabetic neuropathy system (DNS).The patients were divided into two groups:HbA1c＜7.0％ group (65 cases) and HbA1c ≥ 7.0 ％ group(54 cases).Results The disease course[(12.1±8.5)years vs.(16.6±7.5)yeas,t=3.01,P=0.003],UAER[(20.2±11.9)μg/min vs.(47.0±21.4)μg/min,t=2.48,P=0.015] and incidence of diabetic nephropathy [23.1％(15/65)vs.50.0％(27/54),x2=9.36,P=0.002] were all less in HbA1c＜7.0％ group than in HbA1c ≥ 7.0％ group,while the levels of FC-P and 2hC P were higher in HbA1c＜7.0％than in HbA1c ≥ 7.0％ group[(2.1±1.2)μg/L vs.(1.5±1.0)μg/L,t=1.87,P=0.042; (6.5± 3.3)μg/L vs.(4.3 ± 2.9) μg /L,t =2.10,P =0.037].The proportion of patients who took oral hypoglycemic agents was increased while those who received insulin therapy decreased in HbA1c＜7.0％ group (all P=0.000).The α-glucosidase inhibitors were the most commonly used in each group,followed by metformin and insulin secretagogue,and the thiazolidinediones were rarely used,while there was no significant difference in the proportion of medicine between the groups.The overall incidence of symptomatic hypoglycemia was 23.5％(28/119).It was higher in HbA1c ≥ 7％ group than in HbA1c＜7.0％ group[33.3％(18/54)vs.15.4％(10/65),x2 =5.20,P=0.022].However,71.4％(5/7)of the patients with hypoglycemic coma came from HbA1c＜7.0％ group.Conclusions There are obvious individual differences in blood glucose control and complications among senile type 2 diabetes patients,thus the characteristics of the elderly should be considered in the choice of drugs while hypoglycemic events should be paid more attention.

Interleukin-10 (IL-10) is an immuno-regulatory cytokine,which is well known for its immunosuppressive function.IL-1O can act on a variety of immune cell subsets and play an immunosuppressive effect through a variety of ways.It plays an important role in the tumor immune escape.Recent studies show that IL-10 also has an immune-stimulating function,which is presumably a pluripotent cytokine.This paper will combine the latest literature to summary the positive and negative regulatory roles of IL-10,mediation ways in the tumor and the relationships with prognosis.

LDM, a product of the combination of contemporary information network technology and the tradi tional medical mode, is a rapidly developing new undertaking of recent years. The transformation of the medical mode in the establishment of LDM has brought about a series of problerms, including quality control of LDM, delegation of responsibility in IDM, standardization and unification of LDM, and psychological problems of patients under the mode of LDM. These problems present issues of new contemplation and exploration for hospital managers.

Objective To investigate the effect of seasonal variation of blood pressure (BP) on the incidence of cardiovascular and cerebrovascular events in the elderly aged 80 years and over.Methods The 67 patients (aged 80-86 years) with essential hypertension were enrolled, the BP were measured at home, in consulting room, and by 24-h ambulatory BP monitor in every season for 2 years. The incidences of cardiovascular and cerebrovascular events were recorded in the meantime.Results Both systolic BP (SBP) and diastolic BP (DBP) were lower in summer than in any other season (P＜0. 01 ). SBP was higher in winter than in any other season. (P＜0.01), DBP was higher in winter than in summer(P＜0. 01). There were no significant differences in SBP and DBP between spring and autumn. The incidence of cardiovascular and cerebrovascular events were higher in winter and summer than in spring and autumn (P＜0.05). The season (OR= 1. 525, P=0. 001), BMI (OR =1.145, P=0.018) and heart function (OR= 2. 037, P=0.01) were related to the incidence of cardiovascular events. And the season (OR = 1. 604, P= 0. 001 ), history of cerebrovascular disease (OR= 1. 598, P=0. 034), office-measured SBP (OR=0.960, P=0.013) and ambulatory DBP (OR =0. 936, P = 0. 008) were related to the incidence of cerebrovascular events.Conclusions The blood pressure measured by three methods in the elderly aged 80 and over shows that both SBP and DBP are at the lowest in summer; SBP is at the highest in winter, DBP is higher in winter than in summer. There are no significant differences in BP between spring and autumn. The incidences of cardiovascular and cerebrovascular events are significantly higher in winter and summer than in spring and autumn.

Objective To compare the model for end-stage liver disease (MELD) and PT in survival prediction of hepatitis B patients with acute-on-chronic liver failure. Methods One hundred and thirty-nine hepatitis B patients with acute-on-chronic liver failure were divided into survival and death group, and evaluated by MELD and FT. The area under ROC curve was used to compare the MELD and PT. The mortality was observed within 3 months. Results The MELD score and PT of survival group was 25.09 ± 3.92 and (26.46 ± 6.46) seconds respectively, and those for the death group were 36.25 ± 6.42 and (40.78 ± 10.80) seconds. The differences were of statistical significance ( P < 0.01 ). MELD score showed significant correlations with PT(r =0.824, P <0.01). The area under ROC curve was 0.936 (95% CI 0.895 ± 0.977 ) on MELD score and 0. 890 (95 % CI 0.839 ± 0.941 ) on PT, and there was no significant difference between them. Conclusions Both MELD score and PT can accurately predict the short-term prognosis of hepatitis B patients with acute-on-chronic liver failure. The validity of prognosis by MELD is similar to PT. The mortality increases with the MELD score and PT increasing.

OBJECTIVE To study Pseudomonas aeruginosa infection in respiratory tract of severe neurosurgery patients after tracheotomy,and discuss the prevention and management of nosocomial infection.METHODS The data of 19 severe patients admitted in neurosurgery from Dec 2005 to Oct 2007 who underwent tracheotomy were analyzed retrospectively.RESULTS Respiratory tract infection occurred in all 19 cases,the incidence rate was 100%.Eleven species and 73 strains of pathogenic bacteria were found.Thirty(41.10%)strains of P.aeruginosa were found in 12(63.16%)cases,the drug resistance rate was higher.CONCLUSIONS P.aeruginosa is the most important pathogenic bacteriaum of respiratory tract nosocomial infection in severe neurosurgery patients after tracheotomy.Strengthening the sterilization,isolation and airway management and selecting antibiotics based on drug sensitive test are the important methods to prevent and control infection.

OBJECTIVE To investigate the infection status and antibiotic susceptibility of Mycoplasma in our area,so as to instruct the rational use of antibiotics.METHODS Genitourinary secretions were collected with swabs.They were cultured with the diagnostic kit of Mycoplasma(Biomerieux Company).Meanwhile the susceptibility of Mycoplasma against 9 antimicrobial agents was tested with the same kit.According to the instrnction of the kit,the results were read.The data were statistically analyzed.RESULTS A total of 382 samples were collected,and the positive rate was 44.8%.which were composed by Uu 69.6%,Mh2.9%,and Uu+Mh infection 8.8% and low titer Uu+Mh infection 18.7%.The result of drug sensitivity showed that sensitivity of Mycoplasma to pristinamycin PRI,86.5% was the highest,then was to JOS(84.8%)and CIP(26.3%).CONCLUSIONS Ureaplasma urealyticum is the major cause of infection in genitourinary system.It shows serious resistance to commonly used antibiotics.Sensitive antibiotics should be selected based on the results of bacterial culture and drug sensitivity tests so as to raise the clinical curative effects.

Tie2 expressing monocytes (TEMs) only present in human circulating blood and tumor organs,and have an important role in tumor angiogenesis and progression.TEMs are effectively recruited to tumors by angiopoietin 2 (Ang2) and hypoxia and then differentiate into macrophages,which promote the angiogenesis in experimental tumor models by providing paracrine support to nascent blood vessels.Studies show that TEMs are up-regulated in hepatocellular carcinoma,colorectal cancer,breast cancer,malignant glioma and other human cancers,which suggests that TEMs are conducive to diagnosis and prognosis of tumors.With the further research,TEMs are applied to deliver drugs which can obtain significant anti-tumor responses and inhibit metastasis with the ability of tumor-homing.Meanwhile,TEMs may also be a potential target for the anticancer drugs.However,the present researches indicate that the effects of TEMs in tumor microvessel density,clinical stage and prognosis are still questionable.Current works that aim at describing and predicting the concrete function of TEMs have attracted significant attention from researchers.