Cardiovascular disease (CVD) is one of the major complications of type 2 diabetes mellitus (T2DM), which results in a high risk of mortality. Thus, the cardiovascular safety of new anti-diabetic agents has become an important prob?lem with wide concern. There are two classes of incretine-based medications: glucagon-like peptide-1 receptor agonist (GLP-1RA) and dipeptidyl peptidase-4 (DPP-4) inhibitor (DPP-4I). It has been demonstrated that GLP-1RA and DPP-4I possesse beneficial actions in both animal models of cardiovascular dysfunction and patients with ischemic heart diseases. However, their effects on the cardiovascular system in diabetic patients with heart diseases are still uncertain. Here, we sys?tematically reviewed the effects of GLP-1RA and DPP-4I on cardiovascular system to provide more evidence of incretin-based therapy application for diabetes and complications.

Objective　To obtain staphylococcal enterotoxin B (SEB) mutant with normal antigenicity but low toxicity. Methods　Using PCR technique, normal SEB (SEB-N) gene which was amplified from S. aureus S6B. SEB mutant gene (SEB-M) was prepared from the same strain, but one nucleotide in SEB gene was changed from asparagine (N23) to serine (S23). SEB-N and SEB-M were cloned into procaryotic expression vector pTrc99A then and transferred into E. coli JM109. SEB-N and SEB-M which were cloned into plasmid were sequenced directly by dideoxynucleotide method. The crude expressed proteins were identified by double agar immunodiffusion. The level of IL-2 in supernatants of mouse splenocytes stimulated by crude expressed proteins was determined by ELISA. Results　SEB-N and SEB-M were obtained through PCR. The sequence of SEB-N was changed with non site-directed mutagenesis, threonine at the residue 150 of SEB-N was replaced with alanine (ACT→GCT, T150A). As being expected, at the residue 23 of SEB-M, serine substituted for asparagine (AAT→AGT, N23S) with site-directed mutagenesis. Double agar immunodiffusion showed obvious precipitin line with anti-SEB by both crude SEB-N and SEB-M mutant proteins could produce, but not by non-recombinant strain. ELISA demonstrated that the level of IL-2 in supernatant of mouse splenocytes stimulated by natural SEB protein (containing equal amount of JM109P crude protein) was 40 times as much as that stimulated by SEB-M and 12.5 times as much as that stimulated by SEB-N. Conclusions　We obtained two recombinant strains which produced T150A and N23S mutant SEB protein. The mutant proteins showed binding ability to anti-SEB as the normal protein. However, their biological activity as superantigen decreased sharply. We consider that it is promising for further study of molecular adjuvant or superantigen vaccine.

Surgical treatment is the treatment of choice for gastrointestinal stromal tumor (GIST).A consensus on the surgical principle of GIST has been made based on the 10-year experience,which effectively guided the standardized treatment of GIST.Laparoscopic and gastrointestinal endoscopic techniques were applied in the treatment of GIST,and promote the development of the diagnosis and treatment of GIST.Laparoscopic treatment has become one of the main treatment methods for GIST.Furthermore,multi-disciplinary treatment for GIST is gradually adopted in clinical practice.In this article,the prospect of surgical treatment of GIST is introduced based on a 10-year experience.

[Objective]To explore the professor Yu Tugen’s experience, in order to provide reference for clinical medication and the study of atopic der-matitis. [Methods] Treatment based on syndrome differentiation. First, through the analysis of etiology and pathogenesis and clinical manifestations of atopic dermatitis, it is divided into types, respectively analyze each type, discuss the experience in the treatment of various types; then give examples of the treat-ment experience of dampness heat syndromes, analysis of diagnosis and treatment system.[Result]Atopic dermatitis is divided into the types of damp-heat accumulation, spleen deficient aggregates the skin wet, wind formation from blood deficiency. After dialectical treatment, symptom is relieved.[Conclusion] This topic comprehensively summarizes the famous expert Yu Tugen ’s academic thought and clinical experience of atopic dermatitis of the types of damp-heat accumulation, provides a more complete treatment concept based on syndrome differentiation of TCM of atopic dermatitis, to relieve pain and improve the quality of life.

BACKGROUND:Soft tissue releasing is a major means of correcting knee flexion contracture, and the soft tissue releasing methods are different for different knee joint diseases and degrees of deformity. Ideal soft tissue balance can gain a clear functional recovery and deformity correction from severe knee flexion contracture after total knee arthroplasty.
OBJECTIVE:To study the proper handling of knee flexion contracture and soft tissue releasing in total knee arthroplasty.
METHODS:Twenty-six cases of knee deformity in 20 ° to 60 ° receiving primary total knee arthroplasty were retrospectively studies. Steps of soft tissue releasing and residue deformity after each step were recorded. Postoperative fol ow-up was 12 months on average.
RESULTS AND CONCLUSION:The 26 cases were recovered from knee flexion deformity after soft tissue release. Posterior capsular release was carried out in al cases to different extents, and the flexion deformity and postoperative range were corrected and greatly improved, respectively. These indicate that the posterior capsular release and lateral col ateral ligament release can correct most of the flexion deformity, but increasing the distal femoral osteotomy is not necessary.

As a new biomarker and a member of transforming growth factor super family,growth differentiation factor-15 (GDF-15) is increased in some pathological situations,and plays a positive role.Increasing evidence from animals and clinical trials has indicated that GDF-15 is a promising biomarker to be used for diagnosis,screening,risk stratification and prognosis evaluation in acute coronary syndrome,heart failure and pulmonary vascular diseases.However,there are still numerous challenges and problems need to be resolved in the future,such as appropriate cut-off value in diagnosis and risk stratification in different cardiovascular diseases,improvement in sensitivity and specificity,and combinational application with other biomarkers.

Osteoarthritis (OA) is a common chronic arthritis, mainly suffering the middle and elderly patients, and it is the main cause of arthralgia and articular functional disturbance. Studies have suggested that osteophyte formation was closely con?nected with the development of OA due to the stabilization of suffered joints and arthralgia induced by osteophytes. In tissue con?stitution and pathology, osteophyte is made up of bone, cartilage and connective tissue, stemming from MSCs. With the develop?ment of osteophytes, the proportion of bone increases while the proportion of cartilage and connective tissue decreases. What's more, in promotion factors of osteophytes, osteophyte formation was induced by the biomechanical and biochemical factors and their both effect. The biomechanical factors result from imbalance of articular biomechanics induced by cartilaginous degeneration and ligament trauma. And the biochemical factors result from alteration of articular microenvironment induced by metabolic disor?der of chondrocytes and synovitis. Furthermore, the both effects that the biomechanical factors induces biochemical alterations al?so co?promote osteophyte formation. And studies on the mechanism indicated that osteophyte formation was regulated by several signaling pathways and cytokines. TGF?β superfamily and Hedgehog signaling pathway were involved in modulating osteophyte formation. TGF?βand BMPs modulated the initiation and late stage of osteophyte formation respectively. And Hedgehog signaling pathway regulated the osteophyte formation with modulating the hypertrophy of chondral osteophytes. This paper emphatically re?views the development and mechanism of osteophytes in OA for deeply understanding the OA and bringing new ideas and methods for the precaution and treatment of OA.

Objective To assess the safety of living environment by the elderly, further clarify the relevant factors of the elderly fall in the living environment. Methods The self- made assessment form of fall-related factors of living environment for elderly patients was used to survey 1 076 elderly. Likert five grades score was used for each item, and the higher score demonstrated the safer living environment. Results In the assessment of the safety of living environment, the indoor physical environment (3.94 points), home furniture safety (3.66 points) score was better;home ground and the channel (3.32 points) and outdoor activities places (3.57 points) score was lower. Scores of home′s ground and channel, furniture safety, indoor physical environment and living environment of urban elderly were (23.56 ± 6.49), (44.52 ± 7.72), (11.93 ± 2.49), (105.03 ± 17.82) points, which were better than (22.46 ± 6.39), (42.73 ± 7.95), (11.53 ± 2.39), (101.55 ± 18.15) points of rural elderly (t=2.471-3.495, P <0.05). Conclusions The indoor physical environment, home furniture safety got higher scores, and the scores of ground-channel environment and outdoor activities places were relatively lower. Scores of the safety of living environment in urban are better than in rural. It suggests the elderly living environment need to reduce the incidence of falls.

OBJECTIVE:To explore the effect of health intervention on blood pressure,medication compliance and the quali-ty of life in elderly patients with hypertension. METHODS:64 elderly patients with hypertension were selected and randomly divid-ed into observation group and control group,with 32 cases in each group. Both groups were given Amlodipine besylate tablet 5 mg,qd. Control group received routine hypertension knowledge education and regular recheck by guidance. Observation group addi-tionally received health intervention on the basis of control group. The blood pressure control,cognitive level of patients to hyper-tension,medication compliance,the level of trust in physicians and quality score of life were compared between 2 groups before and after intervention. RESULTS:There was no statistical significance in systolic blood pressure and diastolic blood pressure be-tween 2 groups before intervention (P>0.05). After intervention,systolic blood pressure and diastolic blood pressure of 2 groups were decreased significantly,and the observation group was significantly lower than the control group,with statistical significance (P<0.05). There was no statistical significance in cognitive level of patients to hypertension,medication compliance,the level of trust in physicians and quality score of life between 2 groups before intervention (P>0.05). After intervention,the observation group was better than the control group in terms of cognitive level of patients to hypertension,medication compliance,the level of trust in physicians and quality score of life,with statistical significance(P<0.05). CONCLUSIONS:Health intervention can effec-tively improve the cognitive level of elderly patients with hypertension to hypertension,improve the medication compliance and the level of trust in physicians,control blood pressure and improve the quality of life.

Objective:To investigate the clinical efficacy of recombinant human interferon alpha -2b combined with Loop electro-sugical excision procedure( LEEP)in the treatment of cervical ectopic columnar epithelium with chronic cervicitis. Methods:The med-ical records of 68 cases of cervical ectopic columnar epithelium with chronic cervicitis in our hospital from April 2012 to April 2014 treated with LEEP were analyzed retrospectively. The control group(30 cases)was treated with LEEP combined with 5-day postopera-tive oral administration of antibiotics to prevent infection,and the treatment group(38 cases)was given recombinant human interferon alpha -2b through vagina additionally,every other day for 20 days every month after menstrua. After 6 courses of treatment,the clinical efficacy,vaginal bleeding time,vaginal discharge duration,wound healing time and HPV persistent infection were compared between the two groups. Results:The cure rate of the control group was 66. 67%,while that of the treatment group was 92. 11%,and the difference was significant(P<0. 05). Totally 19 cases in the control group were with wound healing(accounted for 63. 33%),while that in the treatment group was 32 cases(accounted for 84. 21%),the difference was significant(P<0. 05). And the vaginal bleeding time,vaginal discharge duration,and wound healing time of the treatment group were all significantly shorter than those of the control group(P<0. 05). After the treatment,the HPV persistent infection rate in the control group was 16. 67%,while that in the treatment group was 0%,and the difference was statistically significant(P<0. 05). The two groups during the treatment process had no obvious adverse reactions,indicating high drug safety. Conclusion:Recombinant human interferon alpha-2b combined with LEEP in the treat-ment of cervical ectopic columnar epithelium is safe and effective,which can effectively shorten the wound healing time,vaginal bleed-ing time and vaginal discharge duration,and is worthy of promotion in clinics.