Diabetic microvascular disease is a severe complication of diabetes mellitus (DM).There are many hypoth-esis for its mechanisms.This overview aimed at effect of C-peptide,coagulant factors,platelet and D-dimer in dia-betic microvascular disease,and provided evidence for its prevention and treatment in clinic.

Objective To understand change and pathogenesis of microalbuminuria(MAU) in cases of adiposity.Method MAU were measured by immunoturbidmetric methods 300 cases of adiposity and 100 cases of nomal children in morning,meanwhile blood press,blood su-gar,blood fat,blood insulin were measured.Results MAU was higher in cases of middle and severe adiposity than normal controls.The diffe-rence was significant(Pa

Objective To observe the mammographic appearance of accessory breast tissue in the axilla. Methods In the past 3 years, 7 562 women were underwent bilateral screen-film mammography. All of the mediolateral oblique(MLO) films were reviewed retrospectively to look for whether there was accessory breast tissue and what the mammographic features were like. Radiographically the accessory tissue resembled the main normal breast glandular tissue but was separated from it. Results Of the 7562 cases, accessory breast tissue in the axilla was detected in 161 cases. The prevalence was 2%. The age ranged from 17 to 70 years (mean, 39 years). 38% of them were found in the bilateral axilla, 42% only in the right, and 20% only in the left. The dimensions on the right ranged from 0.7 to 8.0 cm (mean, 3.5 cm), and that on the left ranged from 1.0 to 7.0 cm (mean, 3.3 cm). There were four types among the accessory breast tissue: patchy type was the most (35%), then the branched type(26%),mixed type(20%), and mass-like type(19%). 3 cases were proved by pathology. Conclusion It is important that the radiologist be familiar with the mammographic appearance of accessory breast tissue in the axilla in order that they could be distinguished from other pathological changes.

The importance and necessity of undergraduates participating in the training plan of the medical research was clarified.Based on the actual ability of students and the characteristic of experimental teaching plan,we think that combination of experimental teaching of small group with research training is a strategy for enhancing the ability of the medical undergraduates to do research.This proposal will speed up the medical educational goal by the activation of novel idea,the cultivation of innovatory thought and the enhancement of creative ability.

Female ; Humans ; Leukemia, Myeloid, Acute ; complications ; etiology ; Middle Aged ; Myelodysplastic Syndromes ; complications ; etiology ; Uterine Cervical Neoplasms ; complications ; drug therapy ; radiotherapy

Wnt signaling pathway is not only closely related to tumor invasion and metastasis,such as cancer cells migration and adhesion,extracellular matrix degradation,and angiogenesis,but also plays an important role in self-renewal,proliferation and differentiation of tumor stem cells.Progress has been made in high specific genes drug development and targeted therapy against the Wnt signaling pathway.

Objective To investigate the effects of penehyclidine hydrochloride combined with ulinastatin on lung injury in patients undergoing cardiac valve replacement with cardiopulmonary bypass(CPB).Methods Sixty ASA Ⅱ or Ⅲ patients of both sexes,aged 33-64,weighing 47-81 kg,NYHA class Ⅱ or Ⅲ ,scheduled for cardiac valve replacement,were randomly divided into 4 groups(n = 15 each): control group(group C),ulinastatin group(group U),penehyclidine hydrochloride group(group P)and penehyclidine hydrochloride + ulinastatin group(group PU).Group U,P and PU received iv injection of ulinastatin 20 000 U/kg,penehyclidine hydrochloride 0.05 mg/kg and ulinastatin 20 000 U/kg + penehyclidine hydrochloride 0.05 mg/kg 30 min after the end of CPB,respectively,while group C received equal volume of normal saline.Then PEEP was increased to 8 cm H2O in all groups.Blood samples were taken at 30 min,3 and 6 h after the end of CPB and 12 and 24 h after operation for determination of PaO2 and serum concentrations of TNF-α,IL-6,IL-8 and IL-10.Airway peak pressure and airway plateau pressure were recorded at the corresponding time points.Oxygen index(OI)and pulmonary compliance(CL)were calculated.Lung injury was scored at 6 h after the end of CPB and 12 and 24 h after operation.Results OI and CL were significantly increased and lung injury score was significantly decreased in group U,P and PU compared with group C(P ＜ 0.05 or 0.01),and in group PU compared with group U and P (P ＜ 0.05).Serum concentrations of TNF-α,IL-6 and IL-8 were significantly lower and the serum IL-10 concentration was significantly higher in group U,P and PU than in group C(P ＜ 0.05 or 0.01),and in group PU than in group U and P(P ＜ 0.05).There was no significant difference in the indices mentioned above between group U and P(P ＞ 0.05).Conclusion Penehyclidine hydrochloride combined with ulinastatin can attenuate lung injury by inhibiting inflammatory response in patients undergoing cardiac valve replacement with CPB.

Objective: To investigate the effect ofintestinal trefoil factor (ITF) on the transcriptional activity of ITF promoter and to explore the regulatory mechanismofJanus kinase/signal transducersand activators of transcription(JAK/STAT) on ITF promoter. Methods: The 5' flanking sequence of the ITF gene was cloned from human whole blood genomic DNA by PCR. ITF promoter fragment was cloned and inserted into the pGL3-Basic vector to construct recombinant vector. ITF promoter vector was stimulated with ITF at various concentrations and the luciferase activity was measured. The JAK-STAT3 signal transductionpathway was then blocked by a speciifc inhibitor AG490 to determine the signal pathway involved in ITF promoter activity. Results: Restriction endonuclease analysis and DNA sequencing confirmed that the recombinant plasmid, containing ITF promoter, was constructed successfully. After transient transfection, the activity of ITF promoter was increased signiifcantly in the presence of ITF (P<0.05). Blockage of the JAK-STAT3 signal transduction pathway with AG490 signiifcantly reduced the ITF promoter activity (P<0.05). Conclusion: ITF increases the transcriptional activity of ITF promoter via the JAK-STAT3 signal transduction pathway.

Objective To evaluate the simulation of standardized patients (SP) in objective structured clinical examination (OSCE) for general practice residency training.Methods The simulation levels of 15 SPs were evaluated by 37 examiners with a rating scale of OSCE Examiner Feedback on SP performance from Melbourne University School of Medicine.The evaluation was conducted in history-taking and doctor-patient communication stations of OSCE for general practice residency training.Results The overall scores of SP performance were high and most examiners considered that the performance of SP was realistic and consistent.Among 9 items of rating scale,more than 90％ of the examiners considered that SP performance met or completely met the requirements of OSCE,except the item of preparation for clothing and making up before role playing.Six items of performance in history-taking station and 4 items in doctorpatient communication station reached 100％ satisfaction from the examiners.T test was used to compare the difference of SP performance between the morning and afternoon,and there was no significant difference (P ＞ 0.05).Conclusion The study showed for this group of SPs,the realistic degree and consistency of performance meet the requirements of OSCE,and its stability is not affected by long time continuous performance.

Objective To investigate potential effect and mechanism of dexamethasone ( DEX) on intestinal ischemia reperfusion injury. Methods A total of 18 male C57BL/6 mice were randomly divided into three groups( n=6 each): sham operation group, model control group , and DEX group. Mice in the model control and sham operation groups received intraperitoneal normal saline 0. 5 hour before ischemia, and mice in DEX group received intraperitoneal injection of DEX 10 mg·kg-1 , 0. 5 hour before ischemia. Mice in the model control and DEX groups were placed in the 32 degree infant incubator for 30 minutes after clamping superior mesenteric artery, followed by clamps removal and reperfusion for 24 hours. Mice were then sacrificed to obtain the intestinal tissues. The pathology of intestinal tissues was observed after hematoxylin-eosinstaining ( HE) staining. The mRNA expression level of pro-inflammatory cytokines IL-6, TNF-α and IFN-γ were measured by PCR. The expression of AKT and p-AKT were measured by Western blotting. Results The level of mesenteric injuries in the sham operation group, model control group and DEX group was (4±2),(13±3),(7±2) points, respectively. The mRNA level of IL-6, TNF-α and IFN-γ and the expression of p-AKT were all higher in the model control group. Compared to the model control group, the level of mesenteric injuries, the mRNA level of IL-6, TNF-αand IFN-γin DEX group were significantly attenuated, but the expression of p-AKT were further increased. Conclusion Pretreatment with DEX can reduce intestinal ischemia-reperfusion injury by activating AKT signaling pathway and suppressing inflammation.