Type 1 diabetes includes two categories:autoimmune (type 1A) and idiopathic (type 1B)diabetes.Fulminant type 1 diabetes is a recently discovered subtype of type 1 diabetes with extremely rapid progression of hyperglycemia and ketoacidosis.The prevalence of fulminant type 1 diabetes among acute-onset type 1 diabetic patients is around 15%-20%.Class Ⅱ HLA genotype and virus infection may contribute to its development.The near-normal HbA_(1C) level despite a very high plasma glucose concentration in patients with ketoacidosis is the clue to diagnosis of fulminant type 1 diabetes.Treatment must be started immediately and aggressively when the diagnosis of fulminant type 1 diabetes is made or strongly suspected.

Non-operative treatment in 105 cases of acute traumatic intracranial hematomas confirmed by CT scan is reported. Results were satisfactory except in 6 cases in which operation was performed because of the worsening of their conditions. In this paper, the indication, method, and advantages of non-operative treatment are also discussed. We believe that the change of state of consciousness, size of hematoma, degree of shift of midline structures and cerebral contusion, and type of hematoma are decisive factors in making the choice of operative or non-operative treatment.

Vitamin D and parathyroid hormone (PTH) are two classical hormones modulating calcium and phosphorus homeostasis.The rapid development of modern endocrinology has greatly expanded our understanding of these two hormones.The extra-skeleton effects of vitamin D/PTH are well documented,novel findings regarding to the embryonic and adult parathyroid development,and the changing clinical patterns in certain parathyroid-related disorders have been discovered.

β cell failure is one of the important components in the pathogenesis of type 2 diabetes.Protecting and reversing β cell function is a critical part in diabetes treatments.It has been recently discovered that rather than apoptosis,β cell dedifferentiation into an endocrine progenitor-like stage is the main mechanism of β cell failure,which is closely related with the loss of FoxO1 on β cells.Some of these dedifferentiated β cells even have the potency to convert into α-cells.These great discoveries expand our understanding for the β cell exhaustion during the progression of hyperglycemia.It is worthwhile to reconsider our current treatment strategy for type 2 diabetes,especially during the beginning period,to protect rather than stimulate β cells.It also paves the way to develop a brand-new class of hypoglycemic agent to re-differentiate the already dedifferentiated β cells back into insulinsecreting cells.

[Summary] The concept for the pathogenesis of diabetes is now changing from previousinsulinocentric model andinsulin/glucagon bihormonal model to a recentglucagonocentric model.Glucagon excess rather than insulin deficiency may play a more important role in mediating the glucose derangement during insulin insufficiency.Antagonizing glucagon signaling pathway may become a potential therapeutic modality in diabetes.

Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar status (HSS) are severe acute diabetic complications. This article mainly discusses the definition, mortality rate, pathophysiology, precipitating factors, main clinical manifestations, laboratory findings and principles of treatment in DKA and HHS.

OBJECTIVE Optimizing the infection control process to prevent the infection in the Operating room.METHODS Based on the operating room materials,the problems were found out then with the help of the comprehensive analysis to get the best evidence,finally use the systemic method to optimize the infection control process in the operating room.RESULTS Optimal process was corresponding to the requirements of National Medical department,and has good maneuverability,so it was easy to carry out for the nurses.Comparing the control group and the observation group,we could found: the monitoring of the cleaning of occult blood on surgical instruments(P

microRNAs is a class of non-coding RNA, which is the transcriptional regulator of gene expression at the post transcriptional level.These endogenous non-coding RNA are expressed abnormally in tumor cells, in the tumor cell growth, reproduction, apoptosis and metastasis and other processes play an important regulatory role.Recently, microRNAs was widely regarded as biological diagnostic and prognostic markers of tumor in clinic, has been widely viewed.This article will introduce the important role of miRNA in tumor gene expression, as well as the use of miRNA as a tumor targeted therapy clinical application before the need to solve the problem .

Objective To investigate the production of reactive oxygen species and anti-oxidative protein of neutrophils in patients with coronary heart disease, and to evaluate the role of neutrophil activation in the pathogenesis of coronary heart disease. Methods Reactive oxygen species production was measured by chemiluminescence method, the degranulation of neutrophils was detected by the whole cell patch-clamp capacitance technique, the plasma and intracellular levels of myeloperoxidase(MPO) were quantified by photometry.Results The production of superoxide anion in neutrophils was increased in patients with stable or unstable angina more significantly than control group (344.21?64.4,325.65?65.1 vs 271.53?56.2,P

With the rapid development of neurosurgery,requirement for neuroanatomy is increasing in clinical practice.The authors made a primary exploration on how to teach focal neuroanatomy for neurosurgical postgraduate students.The idea of asking the students to draw focal anatomy was suggested by the author with the purpose of making them learn it positively.Software workstation and clinical neuroradiological work-ups such as MRI and DSA were also applied and evaluated.The authors proposed all these procedures be helpful for comprehending neuroanatomy.