To explore the effect of insulin therapy on serum level of insulin-like growth factor-I(IGF-I)in patients with type 2 diabetes mellitus.The results showed that serum IGF-I level increased[(126.70±51.91 vs 90.04±43.68)μg/L,P<0.01]and was positively correlated with insulin level in patients with type 2 diabetes mellitus after exogenous insulin therapy(r=0.298,P<0.05).

Objective:BALB/C mice model infected with different Dengue Type 2 virus (DV 2) strains was evaluated and dynamic patterns of humoral immune responses caused by the various viral strains were investigated.Methods:The BALB/C mice were multisubcutaneouly injected by different DV 2 strains. The dynamic changes of the anti-DV 2 IgM/IgG antibody were observed in the infected BALB/C mice by the indrect ELISA and the viremia was observed.Results:The productions of specific antibodies in the infected BALB/C mice after primary and secondary injection with different DV 2 strains showed some difference. Howerer, BALB/C mice infected by the DV 2 B strain from a DHF patient showed the prolonged viremia.Conclusion:The dynamic curve of specific antibody and the viremia induced by various DV 2 strain (DV 2 NGC strain.V.DV 2 B strain) were different in some existence.

Objective:BALB/C mice model infected with DV2 NGC strain was evaluated and dynamic patterns of cytokines were investigated.Methods:The dynamic changes of cytokines were observed in the infected BALB/C mice model by indirect ELISA was observed.Results:The dynamic levels of IL-4、IFN-? in the plasma of BALB/C mice after primary and secondary infected DV2 NGC strain were different.The results showed that the levels of IL-4 were significantly increasing in the early primary infected BALB/C mice while that of IFN-? were lower;In secondary infection ,IL-4 reached a peak on the first day( 4294 668 ? 349 038 pg/ml) and then the levels of IFN-? were higher on the forth and eleventh day.The concentrations of the cytokines produced infectious animals had closely relationship with the doses of DV2.Conclusion:Infection eliciting a dominant humonral immune response induced a high expression of Th2-related cytokines,whereas those show some appearance of Th1 cytokines.Th1 response,as described late for the disease infected with DV2 NGC strain,played a role while it inhibited Th2 response to some extend.Thus,it was responsible to recovery.Th cell and the cytokines were critic to the DV infective diseases.

Objective:To analyze one case of diabetes allergic to insulin preparations and investigate the role of clinical pharmacist in the treatment. Methods:Different insulin preparations were tried out after the patient was allergic to one kind of insulin preparation. However, the allergic symptoms were not improved significantly. Clinical pharmacist recommended to use glargine combined with oral hypoglycemic drugs instead of insulin containing protamine for the patient. Results:The allergic symptoms of the patient were improved significantly after the drug adjustment in the hypoglycemic program by clinical pharmacist. The blood glucose was controlled and aller-gic symptoms didn't show again during the hospitalization. Conclusion:Clinical pharmacist can participate in the treatment of diabetes allergic to insulin preparations through identifying allergens accurately and improving individual hypoglycemic program using pharmaco-logical knowledge. It is important to improve the clinical diagnosis and treatment, and ensure and promote the safety of medical treat-ment and drug use.

OBJECTIVE:To investigate the influence of hypoglycemic combined with lipid-lowering statin therapy on lipid profile of mixed dyslipidemia patients with T2DM and TG in 2.3-4.5 mmol/L. METHODS:In total of 80 patients with T2DM and mixed dyslip-idemia of TG in 2.3-4.5 mmol/L in our hospital was determined according to the patient’s age,chronic complications of diabetes and life expectancy. Hypoglycemic(insulin joint oral hypoglycemic drugs,or oral antidiabetic drug alone)treatment was given according to corresponding target,meanwhile statin lipid-lowering therapy was also given. HbA1c,TG,TC,HDL-C and LDL-C were determined and BMI was calculated before treatment. Alipid was reviewed after two weeks,then the difference was compared. RESULTS:Com-pared with before treatment,TG,TC and LDL-C were decreased by 50.28%,42.91% and 44.37% after hypoglycemic combined with lipid-lowering statin therapy,with significant difference(P<0.01). Insulin was the better choice to reduce the level of TG,there was significant difference between insulin treatment and oral hypoglycemic drugs alone (P<0.05). CONCLUSIONS:For T2DM patients with mixed dyslipidemia of TG between 2.3-4.5 mmol/L,hypoglycemic combined with lipid-lowering statin therapy can not only signifi-cantly reduce the levels of TG,TC,LDL-C and TG to 2.3 mmol/L or less,and even normal. Compared with oral hypoglycemic drugs alone,the compliance rate of TG was higher in the combination of insulin and oral hypoglycemic drugs.

Objective: To investigate the characteristics of fall injuries among primary and middle school students in Yinzhou District, Ningbo City, Zhejiang Province from 2010 to 2022, so as to provide insights into prevention and control of fall injuries among primary and middle school students. Methods: Data of 6 to 17 year-old primary and middle school students with initial diagnosis of fall injury from 2010 to 2022 were collected through Injury Subsystem of Zhejiang Provincial Chronic Disease Surveillance Information Management System. The time, place, activity and clinical characteristics of fall injury were analyzed using a descriptive method. Results: Totally 7 808 fall injury cases among primary and middle school students were reported in Yinzhou District from 2010 to 2022, accounting for 45.72% of the total injury cases in the same age. There were 5 413 boys and 2 395 girls, with a boy/girl ratio of 2.26∶1. Primary school students were the majority, accounting for 55.10%. The incidence of fall injuries among girls, junior high school students and high school students showed increasing trends from 2012 to 2022 (both P<0.05). The primary peak of fall injury was from September to November, and the secondary peak was from May to July, with 4 510 cases (57.76%). The place of fall injury development mainly included schools (2 680 cases, 34.32%), homes (2 343 cases, 30.01%) and streets/urban areas (2 247 cases, 28.78%). The activities at the time of fall injury mainly included leisure time (3 490 cases, 44.70%), sports (2 861 cases, 36.64%) and school activities (1 094 cases, 14.01%). Soft tissue injury was the main characteristics (6 224 cases, 79.71%). Lower limbs (3 101 cases, 39.72%), head (2 419 cases, 30.98%) and upper limbs (1 974 cases, 25.28%) were the main injury sites. Mild injury was predominant (5 896 cases, 75.51%). Conclusions Boys and primary school students are high-risk groups of fall injury in Yinzhou District, schools are high-risk places of fall injury. Schools should be regarded as key intervention places and health education on fall injury prevention should be strengthened.

Objective: To analyze the association between latent class of health-risk behaviors and depressive symptoms among middle school students, so as to provide the evidence for the prevention and intervention of depressive symptoms among middle school students. Methods: Students in two junior high schools, two senior high schools and one vocational high school in Yinzhou District, Ningbo City, Zhejiang Province, were selected using a stratified multi-stage cluster sampling method. Demography and health-risk behaviors were collected using questionnaire surveys, depressive symptoms were investigated using the Center for Epidemiological Studies Depression-10 Scale, and latent class analysis was conducted for health-risk behaviors. The association between different latent classes and depressive symptoms was analyzed using a multivariable logistic regression model. Results: A total of 1 247 students were surveyed, including 641 boys (51.40%) and 606 girls (48.60%). There were 452 junior high school students (36.25%), 532 high school students (42.66%) and 263 vocational high school students (21.09%). Latent class analysis showed that health-risk behaviors in students were classified into three groups, namely healthy behavior group (52.93%), poor diet group (39.94%) and high-risk behavior group (7.14%), and the detection rates of depressive symptoms were 7.12%, 18.88% and 52.81%, respectively, with a statistically significant difference between groups (P<0.05). Multivariable logistic regression analysis showed that after adjusting for age, gender, native place, only child and living on campus, the poor diet group (OR=3.107, 95%CI: 2.086-4.627) and high-risk behavior group (OR=15.401, 95%CI: 9.031-26.262) had higher risks of depressive symptoms compared with the healthy behavior group. Conclusion Having high-risk behaviors and poor diet may increase the risk of developing depressive symptoms among middle school students.

Objective To discuss the clinical effect of dynamic hip screw(DHS)and microtrauma dynamic hip screw(MTDHS)in treatment of comminuted intertrochanteric femur fractures in the elderly patients.Methods From September 2006 to July 2009,42 patients with comminuted intertrochanteric femur fractures were treated by DHS and MTDHS.According to Evans classification,there were 16 patients with type Ⅲ fractures and six with type Ⅳ fractures in MTDHS group and 15 patients with type Ⅲ fractures and five with type Ⅳ fractures in DHS group.The operation time,amount of bleeding,hospital stay and postoperative hip function were evaluated.Results All patients were followed up for 9-17 months(average 13 months).Harris score was 76.4 points in 20 patients treated by DHS and 89.8 points in 22 patients treated by MTDHS,with better functional restoration,shorter operation time and less amount of bleeding in MTDHS group than DHS group.Conclusions Compared with DHS,MTDHS has advantages of minimal invasion,minor trauma,sound recovery of hip joint function and low incidence of complications and hence is a good choice for treating intertrochanteric femur fractures.

Based on the analysis of the current status and limited factors of MISS at home and aboard,this paper discussed on the importance of MISS training base construction and explored the construction from the aspects of infrastructure constructing,teaching staff training,teaching materials compiling and teaching practice(teaching forms,contents and evaluation)researching.

Object To discuss the surgical techniques and the clinical outcomes of the bilateral microendoscopic decompression surgery for lumbar spinal canal and lateral recess stenosis through unilateral approach. Methods 18-ram-diameter microendoscopic tubular retractor was placed with fluoroscopic gnidance, bilateral microendoscopic decompression surgery for lumbar spinal stenosis through unilateral approach were managed by adjusting the angle of tubular retractor. During the procedure, supra-interspinal ligament and contralateral bony lamina were well preserved. Results In the group of single-level microendoscopicdecompression, the mean operation time was 94 min and the mean blood loss was 65 ml. In the group of twolevel microendoscopic decompression, the mean operation time was 135 rain and the mean blood loss was 90 ml. The mean bed rest time was 6.5 days. After operation, the average back pain VAS score decreased from 6.5 to 3.1, the average leg pain VAS score decreased from 7.2 to 2.2, the average Oswestry Disability Index (ODI) decreased from 46.8 to 24.6, which had shown significant statistical difference before and after surgery (P ＜ 0.05). According to Nakai criteria, the excellent and good rate was 84%. Conclusion Bilateral microendoscopic decompression of lumbar canal through unilateral approach under METRx system offers a save, effective and minimal invasive option for lumbar spinal stenosis.