Objective To study the application effect of insulin aspart alone or in combination with metformin to treat diabetes.Methods 80 patients with diabetes from February 2014 to February 2015 were studied.They were randomly divided into observation group and control group,40 cases in each group.The observation group was given insulin aspart therapy combined with metformin hydrochloride tablets.The control group was treated with insulin aspart.The blood glucose levels,insulin dosage were recorded,the incidence of hypoglycemia was analyzed in the two groups.Results After treatment,the blood glucose levels in the two groups were lower than before treatment,the decrease of the observation group was more significant than the control group,the difference was statistically significant (P <0.05).The two groups showed no significant difference in mean blood glucose and glycemic lowest (P >0.05), the highest blood glucose value of the observation group was lower than the control group [(7.3 ±1.1)mmol/L vs (8.5 ±1.8)mmol/L)],there was statistically significant difference (t =3.597 8,P =0.000 2).The average blood glucose level of the observation group was also shorter than the control group,there was statistically significant differ-ence (t =10.880 3,P =0.000 2).After treatment,NIHSS scores of the two groups were decreased,NIHSS score reduce the magnitude of the observation after treatment was significantly higher than the control group (4.33 ± 0.82)vs.(5.24 ±1.25),there was significant difference(t =3.849 8,P =0.000 2).The effect of improving lipid levels observed were significantly better than the control group,the difference was statistically significant (P <0.05). Conclusion Combination of insulin aspart and metformin hydrochloride tablets in the treatment of patients with dia-betes to control blood sugar levels is better than the effect of single treatment with insulin aspart,insulin aspart therapy combined with metformin hydrochloride tablets in patients with diabetes can reduce postprandial 2h,fasting glucose, reduce the incidence of hypoglycemia,it should be popularized and used in the clinical.

Objective To explore the clinical effect of microgranular fat obtained by mechanical injection of autologous fat tissues in the treatment of lacrimal trough deformity.Methods Ten patients in this group were women,and the average age was 28 years.With tumescent technique,the thigh fat granules were aspirated;after the separation and purification using cell sorting screen,fat particles were obtained with uniform size and without fibrous tissue.Through mechanical pushing of the fat particles,the fat granules became chylomicron-like.The fat particles without fibrous tissue were injected into the superficial layer and deep layer of the orbicularis oculi muscle with depressed deformity.3-12 months after operation,the clinical efficacy was evaluated by doctors,patients and the third party.Results In 10 cases of lacrimal groove deformity,9 cases were transplanted once,and 1 case did twice.After 3 to 12 months follow-up the appearance of tear trough deformity was significantly improved,the texture of the ditch of eyelid and cheek skin was soft,and appeared young plump appearance.There were no complications,such as infection,hematoma,fat liquefaction,pigmentation and induration,and satisfactory results were obtained.Conclusions Ultrafine particles of fat are obtained using improved purification method in the treatment of lacrimal groove deformity,and the efficacy is satisfactory.

Objective To discuss the clinical application of different particle size of grain fat sieved by the homogenizing fat extractor.Methods A lot of 68 patients in this group were women,and the average age was 28 years.With the aid of tumescent technique,anterior and lateral thigh fat granules were extracted using liposuction needle;after the homogenizing fat extractor and sieve purification,fat particles were obtained with uniform particle size and no fibrous tissue for different sizes of 2.00 mm,0.90 mm,0.50 mm and 0.28 mm,respectively.After choosing corresponding diameter of fat transplantation needle and appropriate injection level according to fat particle size,the multiple spot and multiple track tunnels,multi-level injection for the facial soft tissue deficiency or cavity were then carried out.With long-term postoperative follow-up,evaluation of different grades were given for the complication,fat survival rate and satisfaction.Results The results were followed up for 3-12 months postoperatively;as responding,the facial appearance of graft field deformity or deficiency was significantly improved and the skin of the recipient area was soft;wrinkles was relieved,and so that they appeared young plump well-pleasing appearance.And there were no complications,such as infection,hematoma,fat liquefaction,pigmentation,induration and so on.Satisfactory results were obtained.Conclusions The treatment of facial soft tissue deficiency or deficiency,by choosing corresponding diameter of fat transplantation needle and appropriate injection level according to the differences of fat particle size sieved by the homogenizing fat extractor,can acheive a high fat survival rate,and stable long-term effect.Thus,this safe and ideal method for rejuvenation of facial treatment is worth promoting.

Objective To understand the trends of the prevalence of hyperuricemia of urbanized community residents Sijiqing Streets in Jianggan district in Hangzhou in the past 4 years,and analyze the correlation between hyperuricemia and metabolic factors,which provide scientific endence for prevention and treatment of hyperuricemia in communities.Methods 1 670 cases equal to or greater than 20 years old were randomly selected to analyze the trends of the prevalence of hyperuricemia in the past 4 consecutive years,which from urbanized community physical examination in 2010 to 2013 (male 749 cases,female 921 cases).Comparative analysis of age,BMI,waist circumference,systolic blood pressure,diastolic blood pressure,fasting blood glucose,glycosylated hemoglobin (HbA1C),TG,TC,LDL-C,and HDL-C levels between hyperuricemia group(male 264 cases,female 181 cases) and non hyperuricemia group (male 485 cases,female 740 cases) on 2013,and analyze the related metabolic factors to hyperuricemia by using non conditional logistic regression analysis.Results ①From 2010 to 2013,male hyperuricemia prevalence rates were 27.9％ (209/749,standardized rates were 27.4％)、29.1％ (218/749,standardized rates were 27.9％),33.2％ (249/749,standardized rates were 31.8％) and 35.2％ (264/749,standardized rates were 32.9％).The prevalence rates of female were 12.6％ (116/921,standardized rates were 11.7％),13.5％ (124/921,standardized rates were 11.9％),18.0％ (166/921,standardized rates were 15.7％) and 19.7(181/921,standardized rates were 17.2％),showed a increased tends year by year (the x2 of tends of male and female were 11.907 and 22.759,respectively,all P ＜ 0.01).In age stratified,the prevalence of hyperuricemia in middle and elder age group were increased significantly (the x2 of middle and elder aged man were 4.387、8.545,The x2 of middle and elder aged woman were 12.043、12.274,all P ＜ 0.05).The annual rate of male was higher than female (the x2 were 61.764、62.060、51.241、51.393,respectively,all P ＜ 0.01).② The male and female hyperuricemia group of age,BMI,waist circumference,systolic blood pressure,diastolic blood pressure,TG,TC,LDL-C levels were higher than those in non hyperuricemia group (the t of male were-2.052,-8.624,-8.772,-3.932,-4.380,-5.006,-3.564,-3.834,respectively; The t of female were-6.021,-8.839,-7.586,-4.702,-4.431,-6.334,-5.317,-5.119,respectively,all P ＜ 0.01),HDL-C levels were lower than those of non hyperuricemia group(the t of male and female were 6.097 and 3.170,respectively,all P ＜ 0.01),fasting blood glucose,HbA1c levels of non hyperuricemia group in female were also higher than the non hyperuricemia group (t =-2.750,-3.711,all P ＜ 0.01),however,Nor was statistical significance in male between the two groups (t =0.432,1.315,all P ＞ 0.05).③The non conditional Logistic regression analysis showed that,independent risk factor for male hyperuricemia were overweight (OR:2.151,95％ CI:1.439-3.215) or obese (OR:2.882,95％ CI:1.541-5.389),hypertension (OR:1.564,95％ CI:1.100 -2.224),dyslipidemia (OR:1.678,95 ％ CI:1.165-2.417) and abdominal obesity (OR:1.708,95 ％ CI:1.146-2.547),independent risk factors for hyperuricemia in women were overweight (OR:2.067,95％ CI:1.290-3.313) or obese (OR:2.843,95％ CI:1.523-5.309),hypertension (OR:1.530,95％ CI:1.042-2.248),dyslipidemia (OR:1.784,95 ％ CI:1.191-2.672) and hyperglycemia (OR:1.768,95％ CI:1.221-2.561).Conclusions The community people have a higher prevalence of hyperuricemia,which showed a increased trend,especially in the middle and old age year by year; overweight or obesity,abdominal obesity,hypertension and dyslipidaemia influence male prevalence rate of hyperurieemia,overweight or obesity,hypertension,hyperglycemia and dyslipidemia influence female prevalence rate of hyperuricemia,we should strengthen the comprehensive prevention and treatment of hyperuricemia in this community.

OBJECTIVETo evaluate the feasibility of developing brain-targeted nasal delivery system of scutellarin by the passage between nase and brain in nasal olfactory area.

METHODThe samples of cerebrospinal fluid (CSF) and blood were prepared by cranial puncture and femoral artery catheterization methods respectively according to the certain sampling time after drug administered. The scuteIlarin concentration of samples were determined by 125 marked method. Pharmacokinetic parameters were calculated by trapezoidal rule. The brain-targeted trendence were evaluated by the value of the index AUC(brain)/AUC(plasma).

RESULTThe distribution of scutellarin in brain following intranasal administration was different between tissues. Drug concentration in olfactory bulb achieved to peak at 5-15 min after intranasal administration, while in brain tissue was 30-60 min. Above all, peak concentration in olfactory bulb and olfactory region respectively were (574.8 +/- 205.), (323.4 +/- 128.3) ng x g(-10, both are higher than CSF, which is (123.2 +/- 29.3) ng x g(-1). Moreover, the distribution of scutellarin given by intranasally in brain was: olfactory bulb (OB) > olfactory region (OR) > cerebrospinal fluid (CSF) > cerebellum(CB) > medulla oblongata (MO) > cerebrum (CR); AUC(0-240) of olfactory bulb, olfactory region and CSF after scutellarin intranasal administration were 5.54, 5.07 and 5.51 times of that after intravenous injection, respectively. And the AUC(0-240) of other brain tissues after intranasal administration were also higher than that after intravenous injection. AUC(brain tissue)/ AUC(plasma) of every brain tissues by intranasally are all higher than that by intravenously remarkably. For instance, 5 min after intranasal administration, the value of AUC(CSF)/ AUC(plasma), AUC(OB)/AUC(plasma), and AUC(CR)/AUC(plasma) were 30.34, 56.93, and 6.14 times of that by intravenously.

CONCLUSIONPart of scutellarin could be straightly transported into brain by the intranasal administration. Its absorption pathway was: the molecule of Scutellarin throughed olfactory mucosa in nasal cavity into olfactory bulb in arachno-hypostegal cavity, and then entered into olfactory region, CSF, cerebrum and cerebellum gradually. It showed that olfactory bulb was the only way for drug molecule to go through nasal cavity into brain. It had a significant trendence of brain-targeted when compared to oral administration and intravenous injection, which indicated a certain feasibility to develop a brain-targeted nasal delivery system for scutellarin.

Administration, Intranasal ; Animals ; Apigenin ; administration & dosage ; pharmacokinetics ; Brain ; drug effects ; metabolism ; Drug Delivery Systems ; methods ; Glucuronates ; administration & dosage ; pharmacokinetics ; Male ; Rats ; Rats, Sprague-Dawley

Objective:To explore the value of magnetic resonance diffusion tensor imaging (DTI) in evaluating cerebrovascular small vessel disease (CSVD) in patients with systemic lupus erythematosus (SLE).Methods:Eighty-two patients with SLE combined with CSVD treated at Yixing People's Hospital from January to December 2022 were selected. They were divided into acute phase infarction group (16 cases), chronic phase infarction group (26 cases), and chronic ischemic lesion group (40 cases) based on routine MRI examination results. All patients underwent DTI examination to obtain the average diffusion coefficient (DCavg) and anisotropy score (FA) of the affected and contralateral normal white matter areas, and the evaluation value of DTI for CSVD in SLE patients was analyzed.Results:The DCavg value on the affected side of 82 patients was significantly higher than that on the healthy side: (11.10 ± 3.48) 10 -3 mm 2/s vs. (8.18 ± 2.42) 10 -3 mm 2/s, and the FA value on the affected side was significantly lower than that on the healthy side: 0.28 ± 0.05 vs. 0.45 ± 0.08, with a statistical significant differences ( P<0.05). The DCavg values of the acute infarction group, chronic infarction group, and chronic ischemic focus group were (11.88 ± 3.50), (9.69 ± 3.24) and (8.52 ± 2.34) 10 -3 mm 2/s, respectively, with statistical significant differences ( P<0.05). The FA values of the acute infarction group, chronic infarction group, and chronic ischemic focus group were 0.28 ± 0.04, 0.33 ± 0.06 and 0.40 ± 0.07, respectively, with statistical significant differences ( P<0.05). The receiver operating characteristic curve was drawn, and the results showed that the area under the curve (AUC) of the acute phase infarction group and the chronic phase infarction group evaluated by DCavg and FA alone and in combination were 0.757, 0.756, and 0.820, respectively. The AUC of the chronic phase infarction group and the chronic ischemic focus group evaluated by DCavg and FA were 0.772, 0.776, and 0.813, respectively. The AUC value of the combined evaluation was relatively large. Conclusions:DTI has good evaluation value for CSVD in SLE patients and can accurately determine the type of CSVD.

Objective:To investigate the surgical method and clinical outcome of using nasal septal cartilage combined with auricular cartilage for management of nasal tip shape.Methods:A clinical study was conducted from April 2014 to June 2019, in which we managed nasal tip shape with nasal septal cartilage and auricular cartilage, and these materials were used as septal extension graft, spreader graft and cap graft. In total, 622 patients (28 males, 594 females; age from 18 to 42 years, mean age 27.47 years) were assessed for eligibility.Results:The follow-up period was from 6 months to 6 years. Nasal shape of all 622 patients was improved significantly after the operation. The nasal tip was natural and round, and there were no complications such as damage of nasal septum mucosa, exposure of prosthesis and infection of surgical site. Only 12 patients were found downward rotation of nasal tip, and 610 patients achieved satisfactory aesthetic results.Conclusions:Using septal cartilage combined with auricular cartilage is a safe, effective and suitable method for management of nasal tip shape.

Objective:To measure and analyze the morphological parameters of nasal septal cartilage obtained by rhinoplasty in Chinese, so as to provide theoretical guidance for clinical acquisition and application of nasal septal cartilage.Methods:From March 2014 to June 2021, 732 patients were received rhinoplasty in Myoung Beaucare Clinic of Beijing-Cosmetic Surgery. During the operation, 12 mm L-shaped nasal septal cartilage scaffold was obtained from nasal septal cartilage for transplantation. Measurement of the length, width, area, maximum thickness and minimum thickness of nasal septal cartilage was performed for further analysis.Results:For nasal septal cartilage obtained from comprehensive rhinoplasty, its length was 1.2 to 3.5 cm, with an average of 2.16 cm; the width was 1 to 3 cm, with an average of 1.84 cm; the area was 1.43 to 10.5 cm 2, with an average of 4.04 cm 2, with a maximum thickness of 0.5 to 3 mm, with an average of 1.92 mm and a minimum thickness of 0.2 to 0.5 mm, with an average of 0.92 mm. Conclusions:In the comprehensive rhinoplasty of nasal septal cartilage for Chinese, the 12 mm L-shaped nasal septal cartilage scaffold is retained, and the average length, width and area of nasal septal cartilage for transplantation are 2.16 cm, 1.84 cm, 4.04 cm 2, 1.92 mm and 0.92 mm respectively.

Objective:To explore the application of nasal aesthetic polygon theory in the reconstruction of new domes on nasal tip with autogenous costal cartilage.Methods:From June 2019 to June 2021, 116 patients (26 males and 90 females) received rhinoplasty, CT-assisted examination of the costal cartilage, nasal bone and nasal cartilage was performed, and the autogenous costal cartilaginous cortex was used to make dome reconstruction grafts that were transplanted to the original alar cartilage and partially fixed to the original nasal septum cartilage to form a satisfactory and natural nasal shape.Results:All the patients were followed up for 6-24 months. No cartilaginous, overrotated or underrotated appearance was found in nasal tip. The shape of nasal tip was clear and good, with an obvious performance point and full lower lobule. The nose was tall and straight, and looked natural and beautiful in three dimensions.Conclusions:The nasal aesthetic polygon theory is used to guide the reconstruction of new domes with autogenous costal cartilage in nasal tip surgery. Compared to the cap and shield grafts, the nasal tip is more close to the normal anatomical structure, the shape and texture are more similiar to the natural state and the nasal tip is softer by using autogenous costal cartilage, and so it is an ideal surgical procedure for nasal tip reconstruction.

Objective:To investigate the effect of autologous costal cartilage cortex as nasal tip support and modified graft for nasal tip contour improvement.Methods:From June 2020 to June 2021, 116 patients (male 26, female 90, aged 20-45 years) who received rhinoplasty in the cosmetic surgery department of Myoung Beaucare Clinic of Beijing, were examined the costal cartilage by CT, and the costal cartilage was cut. The costal cartilage cortex was made into " strip" and " cap" grafts to shape the nasal tip, and the nasal dorsum was raised by polytetrafluoroethylene or silicone prosthesis for comprehensive rhinoplasty.Results:A total of 116 patients were followed up for an average of 11.7 months. After the operation, there was no space occupying in the nasal cavity, no graft protrusion, no obvious foreign body feeling in the nasal valve, and the nasal tip could swing left and right. At the same time, the nasal tip showed obvious signs, the lower lobule was full, and there were no complications such as cartilage appearance, exposure, infection, etc. Due to the untreated deviation of nasal septum, 3 cases had deviation of nasal columella and asymmetric nostrils. The shape of nasal tip was stable in the remaining 113 cases, and satisfactory results were obtained.Conclusions:By using autologous costal cartilage cortex as nasal tip support and modification graft for nasal tip contour improvement, the shaped nasal tip is soft and movable, and does not affect the airway. It is a good surgical technique in nasal tip plastic surgery, which is worthy of clinical application.