ADVANCE trial demonstrated that stable intensive glucose control could improve prognosis and the target HbA1c should be 6.5%.While ACCORD and VADT trials suggested aggressive glucose lowering in diabetics at high cardiovascular risk is potentially harmful,tight glucose control yields no significant effect on long duration,poorly controlled patients with complications.DCCT and UKPDS research confirmed benefits of early intensive glucose control could persist due to legacy effect.Steno-2 research showed patients benefit greatly from comprehensive control of risk factors.In sum,early intensive control of risk factors and individualized treatment in diabetics are mainstream therapy.

Objective To observe the effect of neuromuscular electric stimulation (NMES) on post-stroke dysphagia (PSD). Methods Two hundred patients with swallowing dysfunction after stroke were randomly divided into a control group with 67 cases and a study group with 133 cases. All patients received pharmacotherapy and swal-lowing training. The study group also received NMES. The study group was sub-divided into unilateral and bilateral cortical stroke sub-groups, an ischemic stroke sub-group and a hemorrhagic stroke sub-group. The swallowing levels of the groups were compared after 2 courses of treatment with NMES. Results After an average of 20 days of NMES treatment, the level of dysphagia and its severity improved significantly. The patients with dysphagia due to unilateral stroke improved, on average, more than those with bilateral stroke. Patients with dysphagia due to ischemic stroke improved more than those with hemorrhagic stroke. Conclusions NMES therapy combined with rehabilitation train-ing can significantly improve swallowing in patients with PSD.

Objective To investigate the expression of matrix metalloproteinase-8 (MMP-8) in human breast cancers and its relationship with the clinicopathological parameters,evaluate the relevance of MMP-8 levels to metastases in breast cancer.Methods Human specimens were obtained from 50 patients with invasive ductal carcinomas,and 20 normal breast glands were enrolled.Intact clinical parameters were aviliable for all patients.The protein expression of MMP-8 was determined by immunohistocbemistry technology SP.Results The rate of MMP-8 positive breast cancer was significantly higher than that in normal breast glands [68 ％ (34/50) vs 15 ％ (3/20),P ＜ 0.05].The expression of MMP-8 showed a negative correlation with breast cancer staging.The expression of MMP-8 in stage Ⅰ was higher than that in stage Ⅱ and Ⅲ/Ⅳ[94 ％ (15/16),57 ％ (13/23),55 ％ (6/11),P ＜ 0.05].Lymph node negative patients had a higher MMP-8 expression than patients with lymph node metastases [84 ％ (21/25) vs 50 ％ (13/25),P ＜ 0.05].Conclusion MMP-8 expression is associated with human breast cancer metastases and might be involved in inhibiting metastases.

The significance of identification of mild cognitive impairment (MCI) is to intervene as soon as possible and delay or even prevent its progression to dementia.However,due to the limitations of diagnostic methods and standards,the diagnosis of in patients with MCI is more difficult.In recent years,as an emerging functional neuroimaging technique,resting-state functional magnetic resonance imaging (rsfMRI) has developed rapidly.It has been widely used in the studies of MCI.It may be provide objective biomarkers for the diagnosis of MCI.This article reviews the advances in research on rs-fMRI in MCI.

Objective To investigate the clinical efficacy of fire needling plus moxibustion in treating prurigo nodularis. Methods Ninety patients with prurigo nodularis were randomly allocated to treatment and control groups, 45 cases. The treatment group received fire needling plus moxibustion and the control group, external application of halometasone ointment. Skin lesions and pruritus were scored in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups. Results There were statistically significant pre-/post-treatment differences in the skin lesion score and the pruritus score in the two groups (P<0.01,P<0.05). There were statistically significant post-treatment differences in the skin lesion score and the pruritus score between the treatment and control groups (P<0.01). The total efficacy rate was 81.8% in the treatment group and 60.5% in the control group; there was a statistically significant difference between the two groups (P<0.05).Conclusion Fire needling plus moxibustion is an effective way to treat prurigo nodularis.

Objective To summarize and excavate technical points of acupoint application to intervene infantile recurrent respiratory tract infection based on literature; To provide basis for formulation the standard of the TCM featured therapy. Methods Articles about acupoint application to intervene infantile recurrent respiratory tract infection from CNKI platform (CNKI), Chinese science and technology journals database (VIP), Chinese biomedical literature database (CBM), and Wanfang database were retrived by computers. The medicine, acupoints, the amount of stimulation and the timing for the treatment were analyzed. Results After systematic search, a total of 62 articles were included in the quantitative study, including 6547 patients. The main sticking medicine of 10 highest used rate were:Asari Radix et Rhizoma, Sinapis Semen, Kansui Radix, Corydalis Rhizoma, Cinnamomi Cortex, Astragali Radix, Atractylodix Macrocephalae Rhizoma, Anhelicae Dahuricae Radix, Caryophylli Flos, and Saposhnikoviae Radix, and most of them used ginger juice as anclliary medicine. The acupointwith the highest frequency was Feishu (99.03%), followed by Danzhong, Gaohang, Tiantu, Dingchuan, and Dazhui (28.59%–62.66%). The acupoint application was on the first days of the first, second and third of the three ten-day periods of the hot season, or the first days of the first ninth, the second ninth and the thrid ninth days during the winter time, one dosage for each day. The single sticking time was suggested as 2–4 hours each time (23.44%). Conclusion This study summarizes and evaluates the articles of acupoint application to intervene infantile recurrent respiratory tract standard formulation. infectionin recent years and summarizes the key technical points, which can provide references for clinical and standard formulation.

Objective: To study the effect of levosimendan treatment in patients of dilated cardiomyopathy (DCM) with different heart fraction. Methods: A total of 145 DCM patients were enrolled, based on left ventricular ejection fraction (LVEF), the patients were divided into 3 groups: Mild heart failure (HF) group, the patients with LVEF≤45%,n=15, Moderate HF group, LVEF≤40%,n=58 and Severe HF group, LVEF≤30%,n=72. LVEF, left atrial diameter (LAD), left ventricular end-diastolic diameter (LVEDD) and blood levels of BNP were examined and compared at prior and 7 days after levosimendan treatment respectively. Results: Compared with prior treatment, fater7 days of levosimendan medication, LVEF was elevated at certain degree in all 3 groups, while the statistic improvement was only found in Severe HF group (26.06±3.59) % vs (24.79±2.81) %,P<0.05; LAD and LVEDD had no obvious changes with levosimendan medication in all 3 groups,P>0.05. After levosimendan treatment, blood levels of BNP were decreased in all 3 groups as in Mild HF group (604.80±631.87) pg/ml vs (1252.17±1435.39) pg/ml, Moderate HF group (2369.78±2478.59) pg/ml vs (3206.90±2677.15) pg/ml and Severe HF group (4879.63±5302.42) pg/ml vs (6004.46±5041.59) pg/ml, allP<0.05. The differences of BNP level between prior and after levosimendan treatment, the ratio for BNP reduction were similar among 3 groups, allP>0.05. Conclusion: Levosimendan may, in short term, improve the cardiac function in DCM patients with mild, moderate and severe HF with similar degree; while it could not really change the cardiac structure.

As a stable marker to reflect the average level of blood glucose,HbA1c is very important in glycaemic control evaluation.However,more and more data from evidence based medicine demonstrated that blood glucose fluctuation can also contribute to diabetic complication and prognosis which can not be neglected.Multiple capillary glucose measurements and continuous glucose monitoring are major methods to detect glucose fluctuation.Apart from insulin,various oral anti-diabetic drugs can reduce postprandial glucose excursion.Representative drugs include ?-glycosidase inhibitors,glinides and short-acting sulfonylureas,each have their own way of acting. Abstract:Summ ary:As a stab le m arker to reflect the average level of b lood glucose,HbA1c is very important in glycaem ic control evaluation.However,more and more data from evidence based m ed ic ine demonstrated that b lood glucose fluctuation can also contribute to d iabetic comp lication and prognosis wh ich can not be neglected.Mu ltip le cap illary glucose m easurem ents and continuous glucose mon itoring are m ajorm ethods to detect glucose fluctuation.Apart from insu lin,various oral anti-d iabetic drugs can reduce postprand ial glucose excursion.Representative drugs inc lude?-glycosidase inh ib itors,glin ides and short-acting su lfonylureas,each have the ir own way of acting.

Objective To explore the difference of immunosuppresive effect between the expanded Stro-1+ and Stro-1-subgroups of human mesenchymal stem cells in vitro. Methods Mononuclear cells (MNCs) were isolated from bone marrow (BM) samples and seeded in a T-75 cm2 tissue culture flask contained with Dexter medium. When 50% confluence was obtained, adherent cells were collected and incubated with anti-stro-1 antibody, and the Stro-1+ and Stro-1-MSCs were further seeded for expansion. The total culture time (median) was 15 days. Cells were then analyzed by flow cytometry. One-way mix lymphocyte reaction (MLR) (1?105 responding cells and an equal number of stimulating cells/well were co-cultured in 96-well plates) and nonspecific mitogenic stimuli phytohemagglutinin (PHA) plus interleukin-2 (IL-2) induced lymphocytes proliferation (PBL 1?105/well were mixed with PHA 10?g/ml and IL-2 500U/ml in 96-well culture plates) were established in vitro. 1?103-3?104 irradiated Stro-1+ MSCs and Stro-1-MSCs were added into the two systems at the beginning of reaction. Immunosuppressive actions of both Stro-1+ or Stro-1-MSCs were compared. Results Adherent cells contained a median of 9% (range 5%-26%) Stro-1+ cells, which expressed higher immunophenotype of MSCs. In both reaction systems, suppressive actions occurred in a dose-dependent fashion when whatever Stro-1+ MSC or Stro-1-MSC were added. However, that the addition of 1?103 Stro-1-cells enhanced rather than inhibited the lymphocyte proliferation in one-way MLR. In the presence of various concentrations of MSCs, Stro-1+ MSCs always showed a significantly increased inhibitory effects in comparison to Stro-1-MSCs (P

35), while the expression level of TGF-?1 in Stro-1-MSC was significant higher than that detected in Stro-1+MSC (2-??Ct=0.39, P