The specific features of diabetic microangiopathy include thickening of basement membrane with deposition of a transparent material.Diabetic retinopathy,neuropathy,cardiomyopathy,as well as diabetic foot are the main complications.It remains controversial whether intensive treatment may reduce the clinical renal end point events significantly,while evidence-based medicine confirmed that intensive treatment can reduce the trace and heavy proteinuria,neuropathy,and retinopathy.It will benefit the patients if comprehensive,and standard and,persistent treatments,are started as early as possible,and it consider the features of elderly patients.Managing Older People with Type 2 Diabetes Global Guidelines (IDF) and Chinese Elderly Diabetes Expert Consensus on Diagnosis and Treatment Measures point out that microvascular complications in elderly patients with diabetes closely related to the quality of life,to which we should pay great attention.Early prevention,early diagnosis,early treatment,reach the standard in early stage will be of important clinical significance for the prevention and treatment of senile diabetic microvascular lesion.

Glycosylated hemoglobin A1c(HbA1c)is the products of slow,continuous non-enzymatic saccharification reaction,which can reflect the average blood glucose of 2~3 months of the patients,and it is the most important index for long-term monitoring of glucose.There are so many methods for detecting HbA1c that America,Japan and Swede proposed their own standardized detection methods to reduce the difference laboratories.However,these methods were non-specific.A new method for was developed by International Federation of Clinical Chemistry and laboratory medicine (IFCC) in 2007,which was of high specificity,but which resulted in relatively low glycosylated hemoglobin.To avoid the confusion in reference value of glycosylated hemoglobin,average blood glucose was recommended by American Diabetes Association (ADA),European Association for the Study of Diabetes (EASD),and International Diabetes Federation (IDF).This paper review the origin of average blood glucose substituting HbA1c,relationship of HbA1c with average blood glucose,and the international multiple-center research of ADAG and its enlightenment,and we also discuss the relevant development in future.

ObjectiveTo investigate the diagnosis and trea tment of ankle impin gement syndrome (AIS). MethodsThirty-six cases of AIS encoun tered between March 1995 and May 2001 entered the study. Hereinto, open removals of involved soft tissue were performed in 14 cases after MRI examinations, and arthroscopic exam inations and removals were accomplished in 22 cases. Results Follow-up for 6 mo nths～7 years (mean, 22 months) in all the 36 cases revealed “excellent” outco mes in 9 cases, “good” in 19 cases, “fair” in 7 cases, and “poor” in 1 cas e, showing “good” or “excellent” results in 77 8% of the patients (28/36). ConclusionsArthroscopic examination and operation for AIS is effective.

-6.00D), selected randomly and consecutively, were examined by ICGA and FFA synchronically.ResultsThe result of early phase of FFA showed hypofluorescence of the background in 25 eyes,while of late phase showed subretinal neovascularization (SRNV) in 10 eyes and streak formation in 40 eyes. The result of ICGA showed choroidal retrobulbar arteries in 8 eyes, hypofluorescence of the background in 35 eyes, SRNV in 8 eyes, and streak formation in 52 eyes.ConclusionThe iconographic characteristics of ICGA and FFA of high myopia include hypofluorescence of the background, SRNV and streak formation. ICGA can give more exact information on the lesions of choroid in high myopia. The synchronic examination of ICGA and FFA may act as a guide to the therapy for high myopia.

OBJECTIVE Comparison of the maximum slow-phase velocity of cold and warm air with different stimulated sequence.METHODS Forty normal cases and 229 vertigo cases with bithermal caloric testing during 2004 to 2006 were randomly divided into two groups:20 normal cases and 101 vertigo cases were stimulated with cold air first,and the other cases with warm air first.According to the canal paresis(CP)≥20%,each patients group was subdivided into the normal semicircular canal(SC) function group and the paresis SC function group. The maximal slow-phase velocity(MSV)during the strongest 10 seconds was counted,and compared among the subgroups.RESULTS Except the normal cases with warm air first,the differences between the subgroups were statistically significant.The cold air first group presented stronger MSV with cold air and the warm air first group presented stronger MSV with warm air.CONCLUSION The MSV stimulated by warm air was as the same as that stimulated by the cold air.With different stimulated sequence,the first stimulation induced stronger response.In normal cases,the cold air firstly stimulated induced much more vestibular adaption.

Objective To explore the changes of thyroid hormone and TNF-α in severe patients which occurring under critical illness and to explore the interrelation of these endocrine factors in order to direct clinical therapy. Methods Serum thyroid hormone and TNF-αin 102 severe patients and 80 healthy volunteers were detected by radioimmunoassay and enzymoimmunoassay. The results were analyzed and compared with normal subjects,groups of different prognosis,MODS group and no MODS group. Results TT3,FT4,FT3 levels in severe pa-tients were lower than that in normal subjects(P <0. 01),By contrast,TNF-α level were significantly higher than that of control group (P<0. 01). As the situation became worse,the above changes were more obvious in severe patients as compared with normal subjects. For TT3 and TNF-α level,the differences in the early stages of the disease (3 ~7rd) in the survival group and death group were significant (P<0. 05). Compared with non-MODS group,TT3,FT4,FT3 and TNF-α changed significantly in MODS group(P<0. 05). Conclusion TNF-α and thyroid hormone levels play important roles in the severe patients. The changes of TNF-αand thyroid hormone levels can be used for severe patients prediction and treatment.

Objective To explore the effects of transplantation of endothelial progenitor cells(EPC)from autologous bone marrow for hindlimb ischemia in diabetic rabbit model,and the difference between diabetes and nondiabetes.Methods Rabbits were randomly allocated into three groups for transplantation therapy,PBS control group(n=8,A group),EPC transplantation with diabetes group(n=14,B group),EPC transplantation without diabetes group(n=8,C group).Diabetic rabbit model was established by injecting alloxan,and hindlimb ischemia was induced by complete excision of femoral artery.Diabetic rabbits with hindlimb ischemia were therapied by transplanted ex vivo expanded EPC,and then effects were assessed by capillary density and capillary to muscle fiber ratio,and VEGF in muscle was also determined.Results Capillary density,capillary to muscle fiber ratio,and VEGF in muscle increased significantly in EPC transplantation group with or without diabetes after transplanting 14 days(P

Impotence is one of the more common and serious symptom type of male sexual disturbance.It demonstrates by domestic sampling investigation that about more than 10% of male adult have impotence,and the incidence of impotence goes higher with the growing of age.Warming and invigorating kidney-yang has been the main therapy method for treating impotence.Through years of clinic practices,the treatment for impotence from liver has achieved satisfied effects.

Decoction of Lysimachiae and Artemisia was adopted for the treatment of 54 cases with severe hepatitis in our department from Mar. 1985 to Nov. 1987. The curative rate of 70.33％ was significantly higher than that of the control group of 52 cases(p

Objective To investigate the relationship between accompanying infection and the change of immunologic function in type 2 diabetes mellitus ( T2DM) patients.Methods One hundred and fifteen T2DM patients with infection and 95 T2DM patients with no infection were selected,and 102 subjects with no history of dia-betes were selected as no diabetetes with infection group.The venous blood of all groups were sampled after an over-night fast of 12h.Glycosylated hemoglobin a1c(HbA1c) level was tested by glycosylated hemoglobin automatic analy-zer.The levels of T cell subsets including CD3 ,CD4 ,CD8 ,NK cell and B cell ratio were tested by flow cytometry,Ig and complement level was tested by immune nephelometry.Results The level of body mass indices(BMI) in T2DM patients with infection group[(27.39 ±9.18) kg/m2 ] and with no infection group[(26.15 ±7.39) kg/m2 ] were higher than no diabetes with infection group (24.21 ±5.37)kg/m2 (t =2.548,4.702,all P <0.05).The levels of IgG,IgA,IgM,C3 ,C4 in T2DM with infection group were (11.83 ±3.92)mg/mL,(3.02 ±0.96)mg/mL,(3.38 ± 0.82)mg/mL,(1.70 ±0.38)mg/mL,(0.52 ±0.18)mg/mL,which in T2DM with non infection group were (12.46 ± 2.47)mg/mL,(2.63 ±1.37)mg/mL,(2.91 ±1.79)mg/mL,(1.58 ±0.43)mg/mL,(0.46 ±0.31)mg/mL,which in no diabetetes with infection group were (13.26 ±3.74)mg/mL,(2.06 ±1.86)mg/mL,(2.49 ±1.01)mg/mL, (1.19 ±0.82)mg/mL,(0.30 ±0.05)mg/mL.In T2DM with non infection group and T2DM with infection group, humoral immunity index including the level of IgG was lower and IgA,IgM,C3 ,C4 levels were higher than no dia-betetes with infection group,the differences were statistically significant(t =7.052,23.059,12.617,18.326,8.730, all P <0.05).The levels of CD4 ,CD8 ,NK,CD4 /CD8 ,CD3 were (37.68 ±8.39)%,(31.58 ±6.98)%,(10.76 ± 6.49)%,(1.19 ±0.75),(62.83 ±5.28)% in T2DM with infection group,which in T2DM with non infection group were (39.23 ±10.28)%,(27.61 ±5.65)%,(14.89 ±7.12)%,(1.39 ±1.01),(64.19 ±6.46)%,which in no diabetes with infection group were (42.91 ±5.67)%,(25.17 ±7.25)%,(16.39 ±6.24)%,(1.86 ±0.82), (73.65 ±9.10)%.Cellular immunity index containing CD4 ,CD8 ,NK,CD4 /CD8 ,CD3 levels decreased more signifi-cantly than no diabetic group,T2DMI group compared with T2DM group,the levels of IgG,CD4 ,CD8 ,NK,B cell ratio, CD4 /CD8 ,CD3 decreased obviously,while the levels of IgA,IgM,C3 declined greatly,there were significant differences (t =11.038,8.237,18.549,25.871,2.436,all P <0.05).Conclusion Patients with T2DM have humoral and cellular immunity abnormalities,T2DM patients with infection is closely related with the imbalance of immunologic function.