In recent decades, the mortality and morbidity of diabetes have increased such that it is becoming a major worldwide public health problem. Intensive blood glucose control could significantly raise the patients life and their survival quality nevertheless it develops hypoglycaemia. Repeated hypoglycemia leads to glucose conterregulate deficiencyand hamper reaching glucose target goals. Astragalus, a traditional Chinese herb used in diabetic therapy for thousands years, has also proven its glucose counterregulationeffect on preventing hypoglycemia. Here, we summarize its glycemic regulation mechanism in different extracts. It is projected that the efficacy and safety of astragalus extracts will be proven in clinical trials and animal experiments in future, and this herb extract might be known as a new class of anti-diabetic drug without hypolycemia danger.

Objective To discuss the clinical manifestations and the morphological features of intracranial arteriovenous malformation (AVM) in childhood. Methods During the period from Jan. 2012 to June 2013, a total of 14 AVM patients under the age of 14 years were admitted to authors’ hospital. Of the 14 patients, 11 had a history of spontaneous intracerebral hemorrhage (78.6%), 7 complained of headache (50.5% ), 5 showed signs of unilateral limb weakness (35.7% ), and 2 was accompanied with epileptic attacks (14.3% ). The clinical characteristics, the preoperative imaging features and DSA findings were retrospectively analyzed. Results DSA showed that terminal feeding branches were visualized in 9 cases and blood supply from perforating branches was seen in the remaining 5 cases. In seven cases the feeding artery was single, while in the remaining 7 cases the feeding artery was multiple, and in four of them combination blood supply from both anterior and posterior circulation was found. The lesions were situated at the lateral or convex surface of cerebral hemisphere (n = 5), lateral ventricle (n = 4), cerebral bottom (n = 3) or medial surface of cerebral hemisphere (n = 2). The lesion’s diameter was < 30 mm in 10 cases and (30 -60) mm in 4 cases. According to Spetzler- Martin grading, grade Ⅰ was seen in 4 cases, grade Ⅱ in 2 cases, grade Ⅲ in 5 cases and grade Ⅳ in 3 cases. Conclusion Although in childhood AVM lesion is small in size and lower in grading, its onset is early and the lesion is prone to bleeding. DSA findings indicate that most AVMs in childhood take the form of immature type. Nevertheless, its natural course needs to be further studied.

Objective To explore the value of 18F-fluorodeoxyglucose（18F-FDG）PET-CT and CT in diagnosing bronchioloalveolar carcinoma （BAC）.Methods The PET-CT and CT findings of 15 patients with BAC pathologically confirmed were retrospectively analyzed.Results According to 18F-FDG PET-CT,there was definite diagnosis of malignant in 8 cases（53.3 %）,no exclusion of malignancies in 2 cases （13.3%）,definite diagnosis of benign tumors in 5 cases（33.3%）.The misdiagnosis rate of 18F-FDG PET-CT is higher.According to CT,there was definite diagnosis of malignant tumors in 11 cases（73.3 %）,no exclusion of malignancies in 2 cases（13.3%）,definite diagnosis of benign tumors in 2 cases（13.3%）.Conclusion The false negative rate and the misdiagnosis rate are high when SUVmax as 2.5 was employed as criteria in the diagnosis of BAC.To improve diagnosis accuracy and decrease misdiagnosis of BAC,we should be familiar with the CT images of different BACs and adjust the SUVmax as a diagnosis value.

Replenishing the insulin-producing β cell mass is considered to be a hot topic in the field of diabetes treatment.It has long been known that pancreatic β cells are generated primarily by self-duplication in adults.However,insulin resistance can induce dramatic compensatory β cell mass expansion in the pancreas.Therefore,it is of great value to investigate the etiology and pathogenesis of β cell proliferation under insulin resistance.The recent study has shown that betatrophin,a protein secreted by the liver,modulates β cell growth in response to insulin resistance.We published one article in Diabetes Care titledIncreased circulating levels of betatrophin in newly diagnosed type 2 diabetic patientsto elaborate the relationship between diabetes and betatrophin.

Objective To explore the bone marrow stromal cells,anti-late antigen-4 (VLA-4) antibody (aVLA-4),cytarabine (Ara-C) on the proliferation and apoptosis of leukemia HL-60 cells.Methods The experiment was divided into five groups:HL-60 cells were cultured alone (control group),HL-60 cells and stromal cells group (stromal cells group),HL-60 cells + stromal cells + aVLA-4 (antibody group),HL-60 cells + stromal cells + Ara-C group (drug group),HL-60 cells + stromal cells + aVLA-4 + Ara-C group (antibody +drug group).Cell proliferation or inhibition rate was detected by CCK-8 method,the HL-60 cells apoptosis was detected by flow cytometry.The expression of anti-apoptotic gene bcl-2 in HL-60 cells was determined by Western blot.Results After 24 h and 48 h,treatment,the number of the stromal cells group HL-60 cells were higher than that of the control group with significant difference cultured [(7.2±0.3)×1O5/ml vs (5.3±0.4)×105/ml,(8.4±0.2)×105/ml vs (6.8±0.3)×105/m1,P ＜ 0.001],while the HL-60 cell proliferation inhibition rate [(24.3±2.1) ％,(37.0±2.6) ％,(65.6±3.8) ％] and apoptosis rate [(5.7±0.6) ％,(8.0±0.5) ％,(10.4±0.9) ％,(16.5±0.7) ％] of antibody group,drug group,antibody + drug group were higher than the control group with a difference of statistically significant (P ＜ 0.05),and the increase of antibody + drug group was most obvious.With the decreasing of the bcl-2 protein expression,which was most the decrease of antibody + drug group was most obvious.Conclusion Bone marrow stromal cells can stimulate the proliferation of leukemia cells,aVLA-4 interference the interaction between stromal cells and leukemia cells can enhance the chemosensitivity of leukemia cells to Ara-C.

Objective To investigate the therapeutic effect of oat ?-glucans on liver injury in hyperlipemia rats.Method Rats were fed on high fat forage for 3 w to establish hepatic injury model,then the model group was orally given oat ?-glucans at doses of 133,266 and 533 mg/(kg bw.d) respectively.At the same time,there were 3 control groups including 200 mg/(kg bw.d) chitosan oligosaccharide,normal and liver injury(model group fed with distilled water).Serum levels of ALT and AST,the content of MDA in serum and liver homogenate was assayed.Results Oat ?-glucans at high dose obviously decreased the levels of ALT,AST and MDA in the liver injury models,SP had a better protective effect on the liver injury than oligosaccharide did.Besides,in the treated group with ?-glucans,degenerative and necrotic changes of the liver cells were apparently milder than those of the untreated group.Conclusion Oat ?-glucans can obviously relieve the liver injury in hyperlipemia rats.

Objective To analyze the CT and clinical features of acute pancreatitis(AP) patients with perirenal space(PRS) invasion.Methods CT images and renal function tests(serum urea,creatine) changes of 64 AP patients were retrospectively studied. PRS invasion by inflammation on CT scan and the relation between PRS invasion and renal function changes were analyzed. Results 81% patients had PRS invasion in which 52% were grade B, 25% were grade C. CT features of the PRS invasion varied from mild inflammatory changes to fluid collection or phlegmonous.The PRS invasion was detected in 35 of 52 patients with mild pancreatitis and all severe pancreatitis. Renal function abnormity was 47%, only 3% patients had abnormal renal function in patients without PRS invasion compared to 44% patients with PRS invasion. PRS invasion in patients with abnormal renal function attenuated on CT scan after the pancreatitis was controlled. Conclusions The CT clearly reveals the features of PRS in acute pancreatitis patients. The attenuation of PRS invasion in acute pancreatitis patients on CT parallels renal function recover.

Objective To incestigate the fetures of cranial CT and MRI in the patients with hypertensive encephalopathy. Methods The CT and MRI findings of ten cases of hypertensive encephalopathy with the charge of CT,MRI appearance of FLAIR (fluid attenvated inversion-recovery), DWI(difussion weighted imaging),ADC(apparent diffusion coefficient) were analyzed retrospectively. Results Of ten patients,3 cases had abnormal finding in the cranial CT;10 cases had abnormal finding in the cranial MRI,the lesions were demonstrated as slightly hypointensity on T1WI and slightly hyperintensity on T2WI and remarkably hyperintensity on FLAIR,and iso or slightly hyperintensity on DWI,and remarkably hyperintensity on ADC.The lilateral parietal occipital lobes and cerebellar hemisphere and Brain Stem were the more common sites. Conclusions The only characteristric finding of hypertensive encephalopathy in MRI and CT imaging studies is vasogenic edema,especially in the subcortical white matter of the parietal and occipital lobes bilaterally,and cereballar hemisphere et al;especially FLAIR,DWI and ADC of MRI can be helpful for diagnosis and diffenential diagnosis,prognosis and curative effect of hypertensive encephalopathy.

Objective We sought to evaluate the efficacy of bipolar radiofrequency ablation of atrial fibrillation (AF) in patients undergoing cardiac surgery,and to determine independent factors affecting the recurrence.Methods From June 2007 through February 2010,81 patients with atrial fibrillation underwent a modified Cox-Maze Ⅳ procedure using a biopolar radiofrequency device( Medtronic in 32 cases,Atricure in 49 cases).There were 45 males and 36 females,aged (48.2 ± 11.0)years,including 26 cases of permanent AF,44 cases of persistent AF and 11 cases of paroxysmal AF.The mean duration time of AF was (7.56 ± 7.47 ) years.The left atrial diameter were 36 ～ 72 mm.In conjunction with cardiac surgery including:mitral valve replacement (MVR) (or add tricuspid valve plasty (TVP) in 33 cases,mitral and aortic valve replacement (DVR)( or add TVP) in 18 cases,off-pump coronary artery bypass surgery (OPCAB) in 16 cases,aortic valve replacement (AVR) in 4 cases,MVR and coronary artery bypass grafting (CABG) in 1 case,mitral valve plasty (MVP) in 1 case,and others in 8 cases.Among them,22 patients were undergoing electrophysiological mapping by high-frequency bipolar stimulation from June 2009 to February 2010.A follow-up of 12 to 44 months was completed.Recurrences were evaluated by 12-lead ECG or 24 hour Holter recording every clinic visit-1,3,6,9,and 12 months after the procedure and yearly thereafter,or if symptoms developed.Multivariate regression analysis was performed to determine independent factors affecting the recurrence.Results Hospital mortality was 1.23％.The successful ablation of AF were 100％,82.5％,and 84.8％ immediately after operation,at discharge,and at 2(6.1 ± 13.6) months after operation respectively.Multinomial regression analysis showed small left atrium ( ＜ 60 mm),and electrophysiological mapping might contribute better sinus rhythm restoration ( P ＜ 0.05 ).Conclusion Bipolar radiofrequency ablation of atrial fibrillation in patients undergoing cardiac surgery is safe and effective.Small left atrium ( ＜ 60mm) and electrophysiological mapping should be considered to improve results in selected patients.

Objective To investigate the changes of human penile smooth muscle cell contraction and stretch resulting from the integrin-linked kinase (ILK) gene knock-down.Methods Cultured human penile smooth muscle cells were knocked down for ILK using a small interfering RNA (SiRNA).Cellular ILK expression was quantified by Western blot analysis.Cell attachment,spreading and migration were also performed.Furthermore,microfilament dynamics was tested by means of Alexa Fluor 488 phalloidin stain.Results First,blocking the expression of ILK by siRNA significantly inhibited human penile smooth muscle cell attachment,speading and migration; moreover,ILK down-regulation affected actin cytoskeleton reorganization and changed cell morphology in human penile smooth muscle cell.Conclusions Targeting of ILK with a small interfering RNA not only inhibits human penile smooth muscle cell attachment,spreading and migration,but also effectively suppresses microfilament dynamics.This may be of potential therapeutic usefulness in treating erectile dysfunction (ED).