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

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.

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.

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 effect of dexmedetomidine on the cerebral injury in patients undergoing cardiac valve replacement under cardiopulmonary bypass (CPB).Methods Forty ASA Ⅱ or Ⅲ patients of both sexes,aged 43-64 yr,scheduled for elective cardiac valve replacement,were randomly divided into 2 groups (n =20 each):control group (group C) and dexmedetomidine group (group D).Dexmedetomidine 0.6 μg/kg was injected intravenously over 15 min before induction of anesthesia,followed by infusion at 0.2μg· kg-1 · h-1 until the end of operation in group D.While the equal volume of normal saline was given in group C.Blood samples were obtained from the radial artery and jugular bulb for blood gas analysis before CPB,immediatelv after declamping of the ascending aorta,at the end of CPB and at 6 h after operation (T1-4).The arteriovenous blood O2 difference (Da-jvO2) and cerebral O2 extraction rate (CERO2) were calculated.The plasma concentrations of S-100β and neuron-specific enolase (NSE) in the blood samples obtained from the jugular bulb were measured at T1-4 and 24 h after operation.Results Compared with group C,the jugular venous oxygen saturation was significantly increased and Da-jvO2 and CERO were decreased at T2,3,and the plasma concentrations of S100β and NSE were decreased at T2-4 in group D (P ＜ 0.05).Conclusion Dexmedetomidine can decrease the cerebral O2 metabolic rate and reduce the cerebral injury in patients undergoing cardiac valve replacement under CPB.

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.

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Objective:To investigate the effect of nimodipine liposomes for injection(NOLI)on focal cerebral ischemia/reperfusion(I/R)injury in rats.Methods:Seventy SD rats were divided into NDLI 1.00 mg/kg,NDLI 0.50 mg/kg,NDLI 0.25 mg/kg,nimodipine 1.00mg/kg,solvent 10 mL/kg,sham-operation and ischemic model groups.The model of middle cerelral artery occlusion in rat was replicated.The behavioral scores in rats were assessed in all groups.The infarct volume,brain water content,biochemical indices of brain homogenate and histology were detected.Results:1he NDLI 1.00mg/kg,0.50 mg/kg and 0.25 mg/kg groups could significantly improve the behavior scores in focal cerebral ischemic rats,reduce the volume of cerebral infarction,decrease the brain water content,improve the activities of Na+,K+-ATPase,Ca2+-ATPase,glutathione(GSH)and superoxide dismutazse(SOD)in brain tissues,reduce conteras of malondialdehyde(MDA),lactic acid(LA)and nitric oxide(NO),and improve histo logical injury.Conclusions:NDLI has the protective effect on focal cerebral ischemia/reperfusion injury in rats.