Type 1 diabetes mellitus ( T1DM),arising through a complex interaction of immune,genetic and environmental factors,results from autoimmune destruction of insulin-producing β cells.In up to one third of patients the autoimmune attack is not limited to β cells,but expands into autoimmune polyendocrine syndromes(APS).APS are characterized by functional insufficiency of multiple endocrine organs due to an immunologically mediated destructive process.APS can commonly be divided into three types,including APS type Ⅰ,APS type Ⅱ and immune dysregulation,polyendocrinopathy,enteropathy,X-Linked syndrome (IPEX).Here,we discuss the susceptible factors,clinical manifestation,screening and treatment of APS,with the perspective of the clues they can offer to the pathogenesis and treatment of type 1 diabetes mellitus.

As we known,serum creatinine(Scr),serum urea nitrogen(SUN) and creatinine clearance rate(Ccr),the most established marker of renal function,are affected by age,gender,muscle mass or nutritional status.Scr determines the glomerular filtration rate(GFR) improperly.Serum Cystatin C(sCys C) is freely filtered at the glomerulus and then resorbed and fully catabolised by proximal renal tubules,ma-king it an ideal marker of GFR.It is not affected by gender,muscle mass or malignancy,its production rate is usually constant and its plasma concentration therefore is dependent only on GFR.sCys C has been demonstrated to be more accurate and sensitive than Scr in the detection of early renal impairment and in specific populations may allow for early detection of renal disease.The aim is to discuss the advantages and limitations of sCys C and of established GFR methods.

Objective To understand the microorganisms pollution and the community structure and distribution characteristics of airborne microbes in forest scenic spot in Huangshan,China.Methods The airborne microbes were sampled by fallen plate method from 2002 to 2003 in Huangshan scenic area and Hefei city.Results The results showed that there was a significant negative correlation between the elevation and airborne microbe,the relative coefficient was -0.580(P

Acquired Hyperostosis Syndrome ; drug therapy ; Adult ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Phytotherapy

OBJECTIVETo analyze causes of missed diagnosis of hiding post-malleolar fractures in treating ankle joint fractures of pronation-external rotation type according to Lauge-Hansen classification and assess its medium-term outcomes.

METHODSAmong 103 patients with ankle joint fracture of pronation-external rotation type treated from March 2002 to June 2010,9 patients were missed diagnosis,including 6 males and 3 females,with a mean age of 35.2 years old (ranged, 18 to 55 years old) . Four patients were diagnosed during operation, 2 patients were diagnosed 2 or 3 days after first surgery and 3 patients came from other hospital. All the patients were treated remedially with lag screws and lock plates internal fixation. After operation,ankle joint function was evaluated according to American Orthopaedic Foot and Ankle Society (AOFAS).

RESULTSAll the 9 patients were followed up, and the duration ranged from 14 to 30 months (averaged, 17 months). No incision infection was found, and all incision healed at the first stage. At the latest follow-up, AOFAS was 83.0 +/- 4.4, the score of 4 patients diagnosed during operation was 85.0 +/- 2.9, and the score of 5 patients treated by secondary operation was 81.0 +/- 5.3. All the patients got fracture union observed by X-ray at a mean time of 2.2 months after operation. There were no complications such as internal fixation loosing, broken and vascular or nerve injuries.

CONCLUSIONAnkle joint fracture of pronation-external rotation type may be combined with hiding post-malleolar fractures. So to patients with ankle joint fracture of pronation-external rotation type, lateral X-ray should be read carefully, and if necessary, CT or MRI examination should be performed. If adding lateral X-ray examination after reduction of exterior and interior ankle joint fixation, the missed diagnosis may be avoided.

Adolescent ; Adult ; Ankle Fractures ; False Negative Reactions ; Female ; Fractures, Bone ; diagnosis ; diagnostic imaging ; physiopathology ; surgery ; Humans ; Male ; Middle Aged ; Pronation ; Rotation ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult

Objectives To study the efficacy of the two-compartment peritoneal dialysis fluid with low glucose degradation products in peritoneal dialysis (PD) patients.Methods Pubmed,EBMASE,Cochrane Library,Wanfang,VIP,CNKI,CBM and other databases were searched,at the same time the information form relevant literatures until December 2013 were searched by hand.To be eligible,studies had to be randomized controlled trials that allocated PD patients to two-compartment peritoneal dialysis fluid with low glucose degradation products (low-GPDs group) or to traditional dialysis fluid (control group).The qualities of included articles were assessed and then a meta-analysis was conducted by using RevMan 5.2 software.Results A total of 12 documents,11 studies met the inclusion criteria,and 1 059 cases were included.Meta-analysis results were as follows:(1)the low-GPDs group had higher level of CA125 in peritoneal dialysis effluent,higher residual renal function compared with that in the control group and the weighted mean difference were 19.61 (95％CI 12.04-27.18,P ＜ 0.01) and 0.78 (0.14-1.43,P=0.02),respectively; (2)There was no statistically significant difference between control and low-GPDs group in the ultrafiltration,peritonitis and plasma bicarbonate (all P ＞ 0.05); (3)Four studies showed no difference in peritoneal dialysis technique survival between the two group (P ＞ 0.05).Conclusions The two-compartment peritoneal dialysis fluid with low glucose degradation products is effective and safe,has no negative effects on the frequency of peritonitis,patient' s peritoneal member transport function and plasma bicarbonate,but it causes less mesothelial damage and has higher residual renal function in patients than conventional ones,and does not affect the technique survival time.

Objective:To evaluate the role of spinal cord in anesthesia of isoflurane. Method:The animal models of head bypass were established,which were used to preferentially anesthetized spinal cord, after 9 goats were anesthetized with isoflurane.MAC was determined using tail clamp at prebypass,druing bypass and postbypass. Electroen-cephalogram(EEG),brain stem auditory evoked Potential (BAEP) and visal evoked potential(VEP)were monitored constantly. Result:MAC of isoflurane,the relative power(RP)of ? wave and the latencies of BAEP and VEP were decreased when spinal cord was preferentinally anesthetized (P

Objective Construct the eukaryotic expression vector of inhibitory member of the ASPP family (iASPP) and trans-fect it into colon carcinoma cell lines SW480 and Lovo by liposome .Then observe the expression of iASPP and detect the cell apop-tosis by flow cytometry .Methods The amplified PCR product was digested and inserted into pMD19-T simple vector and sub-cloned into eukaryotic expression vector pcDNA3 .1(+ ) .The recombinant eukaryotic expression plasmid pcDNA3 .1(+ )-iASPP was transfected into colon carcinoma cell lines SW480 and Lovo by liposome ,the iASPP expression was analyzed by RT-PCR .The cell apoptosis was detected by FCM .Results The eukaryotic expression plasmid pcDNA3 .1(+ )-iASPP was constructed success-fully ,the gene squence of iASPP was consistent with that reported (gi 60457962) in GenBank .The mRNA expression levels of iASPP gene of SW480 and Lovo cell lines which transfect the positive plasmid were increased ,and the cell apoptosis rates were de-creased .Conclusion We successfully constructed the recombinant expression plasmid pcDNA 3 .1(+ )-iASPP ,and the plasmid were successfully expressed in colon carcinoma cell lines SW 480 and Lovo ,the cell apoptosis rates of those cell lines were decreased .These facts indicated that reducing the high expression of iASPP may be a new strategy to renew the abilities of P 53 tumor suppressor .

ObjectiveTo investigate the efficacy of co-infusing cord blood (CB) as the third party cells on graft versus host disease (allo-GVHD) prophylaxis after unrelated or haploidentical donor allogeneic hematopoietic stem cell transplantation (allo-HSCT).MethodsFrom 2007 to 2011,41 patients receiving unrelated or haploidentical donor allo-HSCT were analyzed retrospectively.Twenty-five patients received one unit of HLA 4/6-6/6 matched CB one day before SCT as CB group,and median MNC dose was (1.64 ± 0.49) × 107/kg.Sixteen cases not receiving CB served as control group.All patients received antithymocyte globulin,cyclosporine,methotrexate,and mycophenolate mofetil as GVHD prophylaxis.The incidence and severity of aGVHD,and treatment-related mortality were compared between two groups.ResultsThe main clinical characteristics in both groups were comparable.The cumulative incidence of aGVHD in CB group and control group was 44.0％ versus 68.8％ respectively (x2 =2.403,P＞0.05).The cumulative incidence of grades Ⅲ to ⅣV aGVHD in CB group and control group was 16.0％ and 37.5％ respectively (x2 =2.445,P＞0.05).The 100-day treatment-related mortality in CB group and control group was 12.0％ and 12.5％ respectively (x2 =0.002,P＞0.05).ConclusionCord blood as the third party cells might reduce the incidence and severity of aGVHD in unrelated or haploidentical donor HSCT.The efficacy and the mechanism of this strategy need to be further explored by prospective randomized controlled trials.