Objective To investigate the current status of type 2 diabetic patients who failed to achieve the glycemic control target, and provide theoretic evidences for making corresponding strategies. Methods The 2 diabetic patients who failed to reach the glycemic target were recruited from 181 hospitals in 26 cities and received a standard questionnaire, the conditions of their blood glucose level, lifestyle intervention, blood sugar monitoring, and drug therapy were recorded. Totally 3 861 questionnaires with complete information were collected. And the causes which account for glycemic control status were analyzed. Results Among these patients, the mean HbA1c was 7.9%, the mean fasting plasma glucose was 8.2 mmol/L, and the mean postprandial plasma glucose was 11.5 mmol/L. Only 25.6% of patients take their diet control strictly as prescribed and 44. 5% of patients have little exercise. 35. 8% and 47.8% of patients did not monitor their fasting and postprandial plasma glucose,respectively. Glycemic control in the patients aged ＞ 60 years was similar to the younger patients, but the hypoglycemia incidence in the elder group reached 35.5%, which was higher than those in the other 2 groups (20.8% and 21.4%, both P＜0. 05 ). The proportion of patients with mono-therapy and combination therapy was 46. 1% and 51.7%, while the proportion with combination therapy rose in the patients aged ＞60 years (58.7%;Compared with the other age-groups, all P＜0.05 ). 75 % of patients have adjusted their drug administration regimen since initial treatment. Conclusions Inadequate or inappropriate drug therapy regimen is a major cause responsible for this poor glycemic control status. In addition, the unhealthy life styles, insufficient blood sugar monitoring, and poor compliance were also important causes. Thus, for these patients, it is necessary to further enhance patients' education, to improve life style intervention, as well as to select more effective, safer, and compliant drug therapy regimens. Finally, the glycemic control target for the elder patients should be more flexible.

Hormones and epigenetic characteristics in a patient with clinically diagnosed adrenal hypoplasia congenita (AHC) were analyzed. Results indicated that plasma ACTH increased, while cortisol, testosterone, LH and FSH decreased. LH, FSH and testosterone did not sufficiently respond to GnRH or hCG stimulation. Gene analysis indicated that C368F mutation was located in exon 1 of DAX-1 gene.

Clinical and imageological characteristics of Paget's disease of bone in 7 patients who were treated in our hospital from 1991 to 2007 were analyzed. The data showed (1) 6 patients had the symptoms of bone pain and bone deformity, with more long bones involved; (2) Serum alkaline phosphatase was over normal range; (3) Imageology showed that osteoclasia was usually combined with bone sclerosis; (4) All the patients were treated with bisphosphonates; (5) 2 patients with serious bone deformity were treated with orthomorphia. Paget's disease of bone is a kind of metabolic bone disease with the characteristics of osteoclasia combined with bone sclerosis. The main features are bone pain and bone abnormality. Bisphosphonates are the first choice of drugs. Patients with serious bone deformity should be treated with orthomorphia.

为探讨细胞因子对细胞间通讯的影响，应用荧光光淬灭后恢复技术研究白细胞介素（ＩＬ）－１、ＩＬ－６及促甲状腺激素（ＴＳＨ）对鼠甲状腺ＦＲＴＬ－５细胞与细胞间通讯的作用。将培养的ＦＲＴＬ－５细胞加入不同浓度的ＴＳＨ、ＩＬ－１β、ＩＬ－６继续培养１２小时后作荧光染色，以激光扫描仪测定平均荧光恢复速率（ＭＦＲＲ）作为通讯程度的定量指标。结果：（１）用ＴＳＨ后细胞ＭＦＲＲ（单位：％／ｍｉｎ）对照组为０．４４５±０．０３３，０．１、１、５Ｕ／Ｌ组分别为０．６７９±０．０５４、０．９５０±０．０７３、０．７９９±０．０８２（Ｐ＜０．０１）。（２）用ＩＬ－１β后ＭＦＲＲ对照组为０．５６４±０．０３２，１０３、１０４、１０５Ｕ／Ｌ组分别为０．４８５±０．０４２、０．４４５±０．０４３、０．４０５±０．０２９（Ｐ＜０．０１）。（３）ＩＬ－６对ＦＲＴＬ－５细胞胞间通讯无明显影响。提示ＴＳＨ可增强ＦＲＴＬ－５细胞间的通讯，ＩＬ－１β可抑制ＦＲＴＬ－５细胞间的通讯，其作用与ＴＳＨ及ＩＬ－１β的剂量有关。