Recent evidences suggest that inflammatory factors play improtant roles in the pathogenesis and development of type 2 diabetes. The interaction of inflammatory factors with adipokines, oxidative stress and immune system causes insulin resistance and impairment of ? cell structure and function, and results in type 2 diabetes. Inflammation hypothesis of diabetes will provide a new research field in the pathogenesis of diabetes and in the development of new preventive and therapeutic drugs for diabetes.

Systemic insulin resistance has been well known. Recently, an important question has been raised regarding whether islet cells are resistant to insulin (insulin resistance of ?, ? and ? cells) due to the discovery of insulin receptor and its downstream insulin signaling pathways in islet cells. As a new study field of insulin resistance, the elucidation to this issue is crucial for the new insight into the mechanisms of insulin resistance per se and type 2 diabetes.

miRNA is a kind of small,endogenous noncoding RNA which regulates gene expression in post-transcription level and is highly conserved and tissue-specificity,miRNA generally participates the regulation of many complicated vital process,such as cell growth,development and also plays an important role in the pathogenesis of many kinds of tumors,miR-34b is a newly discovered miRNA,which is regulated by p53,promoter methylation and so on.miR-34b can regulate cellular proliferation and apoptosis,and also involves in the generation and regulation of tumor,which suggests wide application prospect in therapy and prognosis of tumor.This review will focus on the progress of miR-34b and its relationship with tumor.

Non-receptor tyrosine kinase c-Abl has been implicated in the regulation of the cell cycle,adhesion, apoptosis and DNA damage responses.Its excessive activation is related with the development of chronic myeloid leukemia, and the relationship between c-Abl and leukemia is in depth and detailed research.In contrast to leukemia, the research between c-Abl and solid tumors is just at the early stage.This paper briefly reviews research progress of the c-Abl in solid tumors.

ObjectiveTo assess the value of intraoperative cholangiography(IOC) for detecting bile duct injury during laparoscopic cholecystectomy.Methods31 cases of bile duct injuries were reviewed regarding the site of injury,mechanism,time of diagnosis,and the place of IOC was evaluated.ResultsBile duct injuries resulted from misidentification in 19 cases.In 12 of these 19 cases,the diagnosis was made by IOC.Primary laparoscopic repair or open repair and T-tube drainage solved the problem without postoperative complications.However,in 3 of the above 19 cases the result of IOC was misinterpreted and in 4 of the above 19 cases IOC was not performed.Two of the 7 patients had aberrant bile duct injuries, in all of them the diagnoses were delayed.There were two cases in which bile duct injury developed after an IOC.ConclusionsCorrect interpretation of IOC enables detecting bile duct injury caused by intraoperatively misidentification and consequent morbidity.

Spironolactone has been widely used in clinical treatment of PA,but its adverse effects are prominent when at large dose.So it is very important for clinicians to choose proper medications and doses for PA.With widespread use of selective aldosterone-receptor antagonists,non-aldosterone antagonists diuretic,calcium antagonists,angiotensin-converting enzyme inhibitors and angiotensin-receptor blocker in treatment of PA,clilicians now have more choice.This review introduces the progress in medications of PA in recent years.

Objective To discuss the mechanism and prevention of bile duct injury in laparoscopic cholecystectomy (LC). Methods Twenty-six cases with bile duct injuries in this study were evaluated retrospectively regarding their location, mechanism, time of detection, repairment and outcome, and the role of intraoperative cholangiography (IOC) in preventing bile duct injury. Results Among a total of 26 cases there are duct injury due to misidentification 15 cases,( IOC detected the misidentification of bile duct injuries intraoperatively 10 cases, clipping the common duct 3 cases, duct thermal injuries 4 cases and duct lacerations 4 cases, Conclusion Duct injury due to misidentification was the main type of bile duct injury in LC, Correct interpretation of IOC will detect the duct injury intraoperatively and prevent the severe consequence. Meticulous dissection and exposure of the junction of distal common hepatic duct, proximal common bile duct, and proximal cystic duct, and safe hemostasis in Calot triangle are the important measures to prevent bile duct injury in LC.

Objective:To develop an economical,simple and portable device for imitation of ship shock motion produced by non-contacting under water explosion.Methods:The device was developed based on aerodynamical principles and sensor detection technology,and was tested with animal experiments to verify its performance.The injuries caused by 4 grades of shock motions with different accelerations,duration and displacement were observed in 40 black rabbits(10 for each grade).Results:The device was safe and functionally stable,with a peak acceleration of 1 000 m/s~2,a shock duration of about 2 ms and a device displacement of 100 mm.The accelerations of 4 shock motion grades were significantly different and with good reproducibility.The damage to the rabbits were mainly haemorrhage of different extents in organs of pleuroperitoneal cavity,especially in the lungs,but no rupture of organs was found.The degree and involvement of damage had an increasing tendency with the increase of acceleration of shock motion.Conclusion:The device we developed can imitate the effects of ship shock motion.

Epidermal growth factor receptor (EGFR), an important target for tumor targeted therapy, is overexpressed / mutated in the majority of tumors. Immune cells modified by chimeric antigen receptor , including T cells, NK cells and so on, is a new technology in recent years, which has showed an unique advantage in the treatment of malignant tumors. In this paper, the research progress of T cells and NK cells modified with chimeric antigen targeting for EGFR and its mutants will be reviewed.

Objective To investigate the relationship between lipocalintype prostaglandin dsynthase(L-PGDS) and visfatin in the lower extremity atherosclerotic plaque. Methods Collected from February 2014 to February 2016 in vascular surgery of our hospital 40 cases of femoral artery atherosclerotic plaque intima specimens (observation group), 20 cases of splenic artery, superior mesenteric artery samples (control group), the expression of visfatin and L-PGDS protein were detected by immunohistochemical staining, and the expression of visfatin and L-PGDS mRNA were determined by RT-PCR. Results The observation group visfatin protein expression was (121.42±11.07), significantly higher than the control group (72.07±12.81), and L-PGDS protein expression was (87.93±9.73), significantly lower than the control group (107.04±10.58), the difference was statistically significant (P<0.05). The relative expression of visfatin mRNA in the observation group was (0.321±0.024), which was significant higher than that of the control group (0.217±0.031), while L-PGDS mRNA was (0.203±0.018), significantly lower than the control group (0.314±0.029), the difference was statistically significant (P<0.05); The expression of L-PGDS protein was negatively correlated with the expression of visfatin protein in the plaque tissue (r=-0.617, P<0.05), visfatin mRNA and L-PGDS mRNA were negatively correlated (r=-0.645, P< 0.05). Conclusion Visfatin and L-PGDS in lower extremity atherosclerosis occurrence and development have an important relationship, both of them may play an antagonistic role.