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 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.

BACKGROUND: The neurological basis for learning and memory is the high plasticity of central nervous system, and special rehabilitative training is necessary in the process of the functional recombination of central nervous system.OBJECTIVE: To observe the capability of rehabilitative training in differentiating learning ability and memory maintaining of one-trial passive avoidance response, and its correlation with the kinetic properties of Nmethyl-D-aspartic acid (NMDA) receptor channel of contralateral hippocampal neuron in rats with cerebral infarction.DESIGN: A randomized control animal trial.SETTING: Department of Rehabilitative Medicine, Affiliated Hospital of Luzhou Medical College.MATERIALS: The experiment was carried out in the central laboratory of Luzhou Medical College between March 2000 and February 2002. Twentyfour male Wistar rats were randomly divided into three groups with 8 rats in each: free movement after cerebral infarction group (model group), rehabilitative training after cerebral infarction group (rehabilitation group) and normal group.METHODS: ① Model establishment: Rats in the model group and rehabilitation group were made into models of infarction of right middle cerebral artery, and those in the normal group were not given any treatment. ②Rehabilitative training: After 4 days, only the rats in the rehabilitation group were trained with rolling-cage exerciser, screen exerciser and balance exerciser for 4 weeks. ③ Learning and memory tests: The learning and memory performances of all the rats were tested at 35 days postoperatively. The Y-maze test was applied to mainly observe the needed number f training for the rats to reach 9/10 correct response (for running to dark arm), and the multi-functional conditioned reflex box to observe the stayed duration on the diving board (step-through latency). ④ The single channel current property of NMDA receptor in hippocampal neurons was recorded with cell adhesion after learning and memory tests.MAIN OUTCOME MEASURES: ① training times needed for the rats to grasp the structure of the maze in each group; ② step-through latency in each group; ③ single channel current property of NMDA receptor in each group.RESULTS: All the 24 rats were involved in the analysis of results. ① The training times needed for the rats to grasp the structure of the maze in the rehabilitation group and normal group were significantly different from that in the model group [(68.02±11.67), (57.62±10.31), (107.07±16.32) times, P ＜0.05], and there was no significant difference between the rehabilitation group and normal group (P＞0.05). ② The medians of step-through latency before shock in the rehabilitation group and normal group were significantly different from that in the model group (286.7 s, 298.4 s, 126.7 s, P ＞0.05), and there was no significant difference between the rehabilitation group and normal group (P＞0.05). ③ The 35 pS short open NMDA receptor channel mainly existed in the hippocampal neurons of rats in the rehabilitation group, the open proportion was 0.099±0.007. The duration and proportion of 20 pS short and long open and the 35 pS short open NMDA receptor channels in the hippocampal neurons of rats were not significantly different from those in the normal group (P＞0.05). In the model group, 20 pS open channel was mainly observed, and the durations of 20 pS short and long open channels were obviously shorter than those in the rehabilitation group, the open proportion of 35 pS short open channel was 0.036t0.04, which was lower than that in the rehabilitation group,but no 35 pS long open channel was observed.CONCLUSION: Rehabilitative training accelerates the recovery of the learning and memory abilities of rats with cerebral infarction by changing the NMDA receptor channel properties of contralateral hippocampal neurons.

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.

Objective To investigate the clinical effect of par ti al pulpotomy in the dreatment of complicated crown fracture of permanent inciso rs with pulp exposure. Methods 44 soldiers suffering from compl icated crown fracture of the incisors with exposure of pulp as a result of injur y 46 during training were enrolled for study. Altogetber teeth were treated with partial pulpotomy, and they were followed-up for 1 to 5 years. Result One of the teeth was found fo have pulp necrosis one year after treatm ent dut to falling off of the filling. The treatment failed in other toeth dut t o polpitis 2 to 4 years later. The treatment was successful in 42 teeth (91.3%) . Conclusion Partial pulpotomy was an effective treatment for c omplicated crown fracture of permanent incisors with exposureof pulp.

Mitochondria play an important role in energy ( ATP ) production through oxidative phosphorylation pathway and the regulation of cell death by apoptosis. Mitochondrial dysfunction has been implicated in the pathophysiology of a number of neurodegenerative diseases. Glaucoma as a neurodegenerative disorder, mitochondrial oxidative stress in the pathogenesis of glaucoma and the damage of RGCs has received close attention in recent years. ln this article, we reviewed the current evidences and recent advances in the relationship between mitochondrial oxidative stress and the RGCs apoptosis.

Objective To identify appropriate subjects for public hospitals social evaluation which fit and match the public hospital social evaluation index system.Methods The methods of literature review,expert consulting and comprehensive evaluation were used.SWOT analysis,appropriateness ranking and classification were made to such six evaluation subj ects as civil servants,medical workers, professional organizations,patients and their family,the public at large and mass media representatives. Results For the support dimension,the top three appropriate evaluation subj ects are professional social organizations,the public at large and medical workers in turn.For the process dimension,the top three subj ects are social professional organizations,civil servants and the public at large.For the result dimension,the top three are professional organizations,the public at large and civil servants.Conclusions Diversified evaluation subj ects independently represented and guided by non-government third-party professional organizations seem a better solution for China′s present specifics.Such a mechanism is authorized by the government,involving patients and their family,the public and social observers,and mass media representatives,supported and coordinated by government departments and public hospitals.

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.

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.

It is important to analyze the epidermal growth factor receptor ( EGFR) mutation before makingstrategyonnon-small cell lung cancer ( NSCLC) patients scheduled to EGFR tyrosine kinase inhibitor ( TKI) therapy .Digital PCR is a new generation of molecular diagnostic technique that provides ultra-highersensitive, specific and absolute nucleic acid quantification based on its unique principle.The application of digital PCR indetecting circulate tumor DNA can be the truly tumorliquid biopsy, helps to acquire the accurate EGFR mutation status from peripheral blood and screen out the most appropriate patients for TKI therapy.This breakthrough technology will also contribute to tumor surveillance and drug resistance monitoring.