It is well established that type 1 diabetes (T1DM) is a T cell-mediated autoimmune disease.Controversial data exist regarding the differential control of the immune system in TI DM.Recent studies have demonstrated that MicroRNAs (miRNAs),single-stranded noncoding RNAs,may play a key role in regulation of gene expression in the immune system.Dicer enzymes or abnormal miRNAs may lead to autoimmune reactions,and thus is expected to become a target for early diagnosis and treatment of T1DM in the future.This article reviews the correlations of known miRNAs with the immune regulation in T1DM and the research progression.

For the past few years, incidence of tuberculotic disease inceased stablely, spinal tuberculosis, as the highest incidence of tuberculosis of bones and joints, has been the focus of the orthopedist study. With the development of recognization of spinal tuberculosis and spinal internal fixation technology, the treatment of spinal tuberculosis has been made a great progress, especially in surgical therapy, many new ways have been found in selection of surgical cases, preparation of surgery, surgical skills and surgical postprocessing. Now summarization is made in this paper.

[Summary] The pathogenesis of type 1 diabetes has not been thoroughly understood. MicroRNA is a kind of small molecule RNA in regulating gene expression at post-transcriptional level. The dysfunction and amount changes of microRNA involve in the regulation of pancreaticβcell volume and function,and thus are related to type 1 diabetes. Here,we reviewed the research advances of microRNA in the development of the pancreas,insulin secretion and type 1 diabetes.

Objective To evaluate the short-term efficacy and safety of concurrent chemoradiotherapy (CCRT) with paclitaxel and lobaplatin for advanced esophageal cancer.Methods Sixty-eight patients with advanced esophageal cancer were randomly divided into two groups according to random number table method:CCRT with paclitaxel and lobaplatin (TL group) and CCRT with DDP and 5-Fu (PF group).The CCRT regimen included radiotherapy at a total dose of 60-70 Gy,and concurrent paclitaxel 60 mg/m2 on d1,a fraction per week for 6-8 weeks,lobaplatin 30 mg/m2 on d2,a fraction per 3 weeks (TL group),and concurrent DDP 75 mg/m2 on d1,5-Fu 500 mg/m2,d1-5,CF 200 mg/m2,d1-5 (PF group).Results All 68 patients were evaluable for response.The response rates were 73.53％ in TL group and 50.00％ in PF group,the median progression-free survival were 13.0 months in TL group and 6.5 months in PF group.There were significant differences (x2 =4.023,P =0.040; x2 =4.512,P =0.034).The incidence rates of Ⅲ-ⅣW degree nausea and vomiting,granulocytopenia and thrombocytopenia were 5.88％ and 35.29％,20.59％ and 32.35％,32.35％ and 8.82％,and the differences were statistically significant (x2 ＝ 8.500,P =0.003 ; x2 =3.200,P =0.041; x2 =6.710,P =0.016).The incidence rates of Ⅲ-Ⅳ degree esophagitis in the two groups were 11.76％ and 17.65％,and there was no significant difference (x2 =1.45,P =0.493).Conclusion The efficacy of TL group in the treatment of advanced esophageal cancer is excellent,and all toxicities are well tolerated.So this protocol may be considered a main regimen in the treatment of advanced esophageal cancer.

Objective To analyze the epidemiological characteristics and trend of human brucellosis in Zibo.Methods The data of brucellosis was derived from China information system for diseases control and prevention, from the epidemiology case study and outbreak event of brucellosis.Descriptive statistical analysis was used to analyze the incidence, the distribution of time, region and population, the transmission, seropositive rate of vulnerable groups, and the epidemiological characteristics of the cases from 2006 to 2014.Results A total of 541 brucellosis cases were reported between 2006 and 2014, the incidence rates increased from 0.16 per 100 000 to 4.94 per 100 000, and cases were found in about 65％ (62/95) of the towns.The disease showed a seasonal cycle with peak period between March and August annually, accounting for 70.61％ (382/541) of the total cases.Vocational high risk population were animal keepers, butchers, sellers and producers, accounting for 73.20％ (396/541), and foodbome infection accounted for 9.61％ (52/541).A total of 8 outbreak events were reported from 2006 to 2014.Conclusions The incidence of brucellosis has increased and the epidemic areas have expanded year by year.Spring and summer are the peak seasons of the disease.Foodborne infection is increasing.

Objective　In order to predict or exclude early ectopic pregnancy.Methods　Endomertrium of 49 early intrauterine and 52 ectopic pregnancy were observed by transvaginal ultrasonography. Trophoblastic artery flow were investigated surrounding the intrauterine embryo or within the endometrium.Results　An endometrial three-line pattern resembled late proliferative endometrium of the normal menstrual cycle were seen in 42 ectopic pregnancy(80.8%). An endometrial three-line pattern were not seen in 49 early intrauterine pregnancy. Thirty-nine early intrauterine pregnancy had trophoblastic artery flow surrounding the intrauterine embryo or within the endometrium. None of ectopic pregnancy had trophoblastic artery flow within the endometrium.Conclusion　Observation of endometrial three-line pattern and trophoblastic artery flow by transvaginal ultrasonography were useful for diagnosing eraly ectopic pregnancy.

Objective To investigate the effect of paclitaxel on the intimal proliferation in rat aortic allografts and the possible mechanism on preventing graft arteriosclerosis.Methods Thirty-two inbred(Wista)r rats and 16 SD rats were divided into three groups:the isografts control group(Wistar/Wistar),the(allografts) control group ((Wistar)/SD) and test group(Wistar/SD) randomly(16 rats each groups).The rat abdominal aortic allograft model was used.The rats in test group were treated with paclitaxel after operation and those in control group with(0.9 %) normal saline.The grafts were removed and measured by means of pathology and immunohistochemistry 30 days later.Results The results showed that the thickness of the(aortic) intima,the degree of inflammatory cells infiltration in adventitia,stenosis ratio and the expression of(PCNA) were decreased in test group as compared with the allografts control group.Conclusions Paclitaxel can inhibit intimal proliferation in aortic allografts and prevent the graft arteriosclerosis.The mechanism is related to inhibition of vascular smooth(muscle) cell proliferation and alleviation of aortic allografts rejection.

Objective To investigate the research status of head nurses of 10 secondary hospitals in Yichang area,to understand the research attitudes and intentions,to provide a reference basis for further research training program.Methods A total of 161 head nurses in 10 secondary hospitals in YiChang were recruited and a questionnaire survey was conducted.Results There are 11.7％ of head nurse involved in research projects,44.7％ of them did not publish paper,and 80％ of them had never received scientific research knowledge and training in school.95.1％ of head nurse think the nursing research is very important,and willing participate in research study,69.6％ of them want to take part in the practical activity.Conclusions The foundation for research in Head nurse is weak inthe secondary hospital with low research achievements,however they have shown a positive scientific attitude,that may improve research ability,the hospital should pay attention to the head nurse research needs,provide effective training,promote nursing research capacity.

Objective To discuss the characteristics and management of pregnancy on cesarean section scar. Methods Five women with pregnancy on cesarean section scar were reviewed from Apr. 2000 to Mar. 2003. Results All of the five patients had cesarean section before and suffered from painless,irregular vaginal bleeding after 6～8 weeks of amenorrhea. The pregnancy could be misdiagnosed as invasive mole or cervical pregnancy. All had better outcome by uterine suction under ultrasound monitoring without massive bleeding or hysterectomy. Conclusions Women who had cesarean section before are in the risk of pregnancy on the old scar. Clear diagnosis should be made before any treatment. Ultrasound monitoring,local MTX injection and packing can be utilized to prevent perforation during suction. Patients should be monitored continuously after operation with serum hCG level and ultrasound. The principle prevention of pregnancy on cesarean section scar is to reduce the cesarean section rate and effective contraception.