Objective To investigate the short-term therapeutic effect of liraglutide injection combined with insulin pump subcutaneous infusion of insulin in the treatment of early-onset obesity.Methods 100 patients with diabetes mellitus treated with endocrine specialist outpatients from May 2015 to August 2016 in our hospital were selected and randomly divided into three groups,insulin+liraglutide injection 1.2 mg/d group(treatment group 1),insulin+metformin 0.5 tid group(treatment group 2)and insulin intensive group(control group).The control group of 20 cases,the remaining 40 cases each group.Each patient was treated with their own treatment regimen.Target blood glucose: fasting blood glucose≤7.0mmol/L,2h postprandial blood glucose≤10mmol/L that is compliance,blood glucose≤4.4mmol/L that low,blood glucose≤3.9mmol/L that low blood sugar.Two groups of patients adhere to three months of treatment.At the time of admission,after 2 weeks of treatment and 6 months of treatment,venous blood was taken for biochemical examination.The corresponding biochemical indicators were compared and the therapeutic effects of the two regimens were compared.Results There were significant differences in the levels of fasting glucagon,fasting C-peptide and body mass index between the two groups after three weeks of treatment and three months after treatment(P<0.05).The total amount of insulin,the time of reaching the standard and the frequency of hypoglycemia of three groups were compared,the difference was statistically significant(P<0.05).Conclusion Using three kinds of treatment for the treatment of elderly obese diabetesmellitus have a significant effect.However,the treatment regimen of insulin+liraglutideinjection 1.2 mg/d is effective in the control of diabetes and the total insulin dosage,as well as the number of hypoglycemia occurred,are better than the other two groups of treatment.

ObjectiveTo evaluate the ability of high resolution magnetic resonance (MR) imaging at 3.0 tesla to depict the characterization of human carotid arterial vessel wall and detect atherosclerotic lesions ex vivo in comparison to histopathologic results. MethodsEighteen carotid arteries obtained from 9 elderly donors underwent fat-suppressed T1 - and T2-weighted MR imaging at 3.0 tesla MR system with a mouse coil. Corresponding histological sections were obtained for the comparison. Correlation between MR images and histopathologic slices was obtained by Pearson or Spearman correlation coefficient.Cohen K was computed to quantify the agreement between MRI and histopathologic findings.Results Lumen area,intima and media area measured on fat-suppressed T2-weighted images showed stronger correlation with the corresponding histopathologic slices [ MRI vs.histopathology:( 27. 53 ± 6. 77 ) mm2 vs.( 25.83 ±6. 69 ) mm2, r2 ＝ 0. 91,P2 ＝ 0. 024, ( 12.31 ± 3. 31 ) mm2 vs.( 12. 28 ± 3.71 ) mm2, r2 ＝ 0. 70, P2 ＝ 0. 020,Median 12. 29 mm2(Min 1.12 mm2, Max 33.18 mm2) vs.Median 11.62 mm2(Min 0.89 mm2, Max 32. 84 mm2 ), r2 ＝ 0. 74, P2 ＝ 0. 016, respectively]. The Cohen K score between the MR imaging and American Heart Association classifications was 0. 74, which corresponds to a good agreement. Conclusions 3.0 T high-resolution multi-sequence MRI can clearly show the structure of ex vivo carotid artery wall and allow quantitative assessment.Fat-suppressed T2Wimaging has a greater advantagein presenting atherosclerotic lesions.

ce, sIMRT and IMRT radiotherapy techniques can protect the lung and spinal cord well.

Objective To assess the diagnostic value of CT spectral imaging using quantitative iodine-based material decomposition images in the evaluation of pulmonary embolism. Methods Fifty-three patients underwent CT angiography with spectral imaging mode on a GE Discovery CT750HD scanner. Iodine distribution in the lung parenchyma using the iodine-based material decomposition images was quantitatively measured by post-processing. Monochromatic CT angiographic images were reconstructed from the same data sets and thee images were reviewed for the identification and localization of pulmonary embolism as well as the degree ( partial or complete) of the embolic occlusion. The number and location of perfusion defects were recorded. The iodine content of perfusion defects and normal lung parenchyma on the iodine maps were measured by one reader using an ROI analysis. Comparative analyses were obtained using the Chi-square test for categorical data. Two independent samples rank test and 2 related samples signed-rank test were used to compare iodine densities between different groups. Results CT angiography showed no pulmonary embolism in 33 patients, and iodine distribution was homogeneous. A total of 93 clots with lobar ( n = 26), segmental (n = 54) and sub-segmental (n=13) distribution were detected in 19 patients; Fifty-one clots were occlusive and 42 clots were non-occlusive. The iodine-based material decomposition images of all occlusive clots showed lobar, segmental or sub-segmental iodine distribution defects; whereas eleven of 42 non-occlusive clots had evidence of iodine distribution defects. There was significant difference ( x2 = 39. 94,P＜0. 01 ) in the perfusion defects between occlusive and non-occlusive clots. There was a significant difference in iodine content between normal lung parenchyma [ (1.92 ±0. 54) g/L] and perfusion defects [ (0. 30 ± 0. 20)g/L] (Z= -5.63, P ＜ 0. 01 ). There was a significant difference in the iodine content of peffusion defects before [ (0. 26 ± 0. 23 )g/L] and after anticoagulation [ (0. 94 ± 0. 50 )g/L ] ( Z = -3.93,P ＜ 0. 01 ). Conclusion With the ability of iodine mapping, CT spectral imaging is areliable method in the evaluation of pulmonary embolism both qualitatively and quantitatively, and may be a useful tool in providing information regarding the severity of PE and monitoring therapeutic efficacy.

Objectives To investigate the clinical significance of dual energy spectral CT (DESCT) in quantitatively differentiating peripheral lung cancers from pulmonary inflammatory masses.Methods Sixty patients with 35 lung cancers and 25 inflammatory masses underwent DESCT to get arterial phase (AP) images and venous phase (VP) images.Iodine concentrations in the central and peripheral zone of the masses were measured and normalized to the aorta as normalised iodine concentration (NIC).The difference of NIC between central and peripheral zone of the masses (dNIC) was calculated.The spectral attenuation curve was obtained automatically and the slope of curve (λHU) was also calculated in the two groups.The quantitative parameters was presented as M (Q1,Q3),and Wilcoxon signed rank test was used to compare above two independent samples.Receiver operating characteristic (ROC) curves were generated to calculate the sensitivity and specificity.Results NICs in the central zone of peripheral lung cancers were significantly lower than that of inflammatory masses:mean NICs were 0.03 (0,0.05) versus 0.12 (0.07,0.20) in AP,and 0.14 (0.12,0.19) versus 0.30 (0.21,0.57) in VP (Z=-4.14,-3.70,respectively,P＜0.01).While the dNIC values of lung cancers were significantly higher than that of inflammatory masses:dNIC values were 0.08 (0.05,0.11) versus 0.04 (-0.02,0.08) in AP,and 0.23 (0.17,0.34)versus 0.07 (-0.04,0.08) in VP(Z=-2.56,-4.00,respectively,P＜0.05).Mean λHU values of lung cancers were also lower than inflammatory masses:1.03 (0.67,1.67)versus 2.75 (1.61,3.19) in AP,and 1.58 (1.30,2.17) versus 3.25 (2.37,4.54) in VP (Z=-3.90,-4.42 respectively,P＜0.01).According to ROC curves,cutoff value of λHU =2.11 in VP had the highest sensitivity (89％) and specificity (91％) in differentiating peripheral lung cancers from inflammatory masses.Conclusions Contrast-enhanced dual energy spectral CT imaging with some quantitative parameters such as normalised iodine concentration,dNIC,and the slope of spectral attenuation curves may be a promising new method for differentiating peripheral lung cancers from inflammatory masses.

Objective To evaluate multi-slice spiral computed tomography(MSCT)in the diagnosis and preoperative staging of gastrointestinal cancer.Methods (1)Three hundred and thirty-two gastric cancer patients underwent preoperative MSCT examination.The staging of gastric cancer by MSCT was compared with histological examination.(2)Seventy-three small intestinal cancer patients underwent preoperative MSCT,and 70 healthy adults were selected as normal contr01.The MSCT images of small intestinal lymphoma and small intestinal cancer were compared with those of normal small intestine.(3)Two hundred and twenty-eight colorectal cancer patients underwent preoperative MSCT,and the features of the MSCT images of colorectal cancer were analyzed by chi-square test.Results (1)The overall accuracy of MSCT in the assessment of gastric wall invasion,lymph node metastasis and distal metastasis were 78.2%(244/312),67.3%(210/312)and 93.8%(30/32),respectively.More information such as the location of lesions and the vessels around the stomach couldbe provided by MSCT image.(2)Abdominal masses,diffuse thickening of intestinal wall and intestinal obstruction were the main features of small intestinal cancer,while mesenterie and retroperitoneal lymph nodes metastases were rarely detected.The presentation of small intestinal lymphoma detected by MSCT were completely the opposite.(3)Signs such as"coarse surface"and"heterogeneous enhancement"were important to the diagnosis of colorectal cancer.The measurement of the MSCT value is helpful in the differential diagnosis of colorectal cancer and colonic inflammation.Conclusions MSCT can provide correct imaging information on the diagnosis and preoperative staging of gastrointestinal cancer.The combination of MSCT and endoscopy can improve the accuracy of diagnosis.

Objective To explore the Schistosoma japonicum cercariae collected method and the quantity of cercariae obtained from a great quantity artificial infected snails. Methods In laboratory condition, Oncomelania snails were infected with schistosome miracidia. Sixty days post-infection all snails were divided into 7 shares. Cercariae shed from 1 share snails every day and the number of all shedding days were 40. Cercariae shed from snails were collected with low-velocity centrifuge and the cercariae sediment were weighted. Results One thousand and nine hundred g snails bred for 120 days post-infection, the infection and survival rates were 36. 00% and 51. 58%. Cercariae col-lected were 10. 5 g from 40 days collection. Cercariae quantity of shedding from 1 000 positive snails per day was 0. 257 4 g.

Objective To observe the molluscicidal effect of 25% suspension concentrate of niclosamide (SCN) against snail eggs and young snails. Methods The experiments with SCN and 50% wettable powder of niclosamide ethanolamide salt (WPN) against the snail eggs and young snails were carried out by the immersion method in laboratory. Results The death rates of snail eggs were both 100% in 0.25 mg/L active content of SCN and in 0.50 mg/L of WPN for 24 hours. The LC_~50(s) of SCN against Oncomelania snail eggs were 0.0506, 0.0496 mg/L and 0.0473 mg/L by immersion for 24, 48 hours and 72 hours respectively, while the LC_~50(s) of WPN were 0.1030, ~0.0962 mg/L and 0.0869 mg/L. The death rates of young snails were both 100% in 0.25 mg/L active content of SCN and WPN for 24 hours. The LC_~50(s) of SCN were 0.0625, 0.0474 mg/L and ~0.0442 mg/L for 24, 48 hours and 72 hours respectively, while the LC_~50(s) of WPN were 0.1088, 0.0825 ~mg/L and 0.0825 mg/L. Conclusion The SCN has high molluscicidal effect against Oncomelania snail in its different developmental stages: egg and young snail.[

Objective To find out the valuable early diagnostic antigen of Schistosoma japonicum. Methods The sera of rabbits were collected at different time after the rabbits were infected with cercariae of Schitosoma japonicum. The fractions of the soluble cercaria antigen (SCA), soluble adult worm antigen (AWA) and soluble egg antigen (SEA) were separated by SDS-PAGE and recognized by Western blotting with rabbits' sera of different time of post-infection. Results In Western blotting, the bands of 94, 48, 41, 40 kDa and 38 kDa of SCA appeared the earliest and were recognized by the rabbits sera of 2-week post-infection, the bands of 71 kDa and 23 kDa of SCA reacted with the rabbits sera of 3-week post-infection strongly. The bands of 71 kDa and 58 kDa of AWA appeared the earliest and were recognized by rabbits sera of 3-week post-infection. The bands of SEA reacted earliestly to the rabbits sera of 4-week post-infection were 270, 151, 73, 69, 50 kDa and 24 kDa. Conclusion The fraction antigens of 94, 71, 48, 41, 40, 38 kDa and 23 kDa of SCA, the fraction antigens of 71 kDa and 58 kDa of AWA and the fraction antigens of 270, 151, 73, 69, 50 kDa and 24 kDa of SEA could be recognized by sera of acute infected rabbits and might have potential early immuno-diagnosis value for schistosomiasis.

Objective To investigate the impact of a single sub-anesthetic dose of ketamine on postoperative emotional reactions of anxiety and depression during colorectal tumors surgery. Methods A total of 42 patients undergoing selective colorectal surgery,aged 18 to 65 years,were randomly divided into ketamine group (group K)and control group (group C).After induction of an-esthesia,a single intravenous injection of 0.3 mg/kg ketamine and saline were used in Group K and group C 5 minutes before the operation respectively.The intravenous analgesia program was identical between the two groups.The patients??emotional reactions (anxiety,depression)were assessed using the Hospital Anxiety and Depression Scale (HAD),the quality of recovery was assessed using the QoR-40 questionnaire on the day before operation and within postoperative 48 hours respectively.Pain was estimated by the visual analog scale (VAS)and sedation was assessed with Ramsay score 30 mi-nutes after extubation.The time of anesthetic end and extubation were recorded.The complications during anesthesia and recovery such as cough, agitation 30 minutes extubation were recorded. Results The HAD-A and HAD-D scores of group K were lower than group C (P <0.05)48 h post-operatively.There was no difference on the QoR-40 score postoperative 48 h between the two groups. The patients??emotional state QoR-40 score of group K were higher than group C (P <0.05 ).The VAS scores 30 minutes after extubation of group K were lower than group C (P <0.05).There was no significant difference on sedation score 30 minutes postoperatively between the two groups.There was no significant difference in extubation time,cough,agitation and delirium between the two groups.There was no dizziness, nausea, vomiting or diplopia 30 minutes after extubation. Conclusion A single subanesthetic dose of ketamine can significantly reduce the scores of postopera-tive anxiety and depression,improve the quality of recovery,and no postoperative adverse reactions increased.