The failure of islet β cell is the core pathogenic mechanism of diabetes,which is also the key target for type 2 diabetic mellitus treatment.A large amount of basic and clinical researches have been confirmed that glucagon like peptide-1 and its analogue liraglutide have abilities to significantly improve islet β cell function besides the glucose-dependent lowering hyperglycemia effects.Furthermore,liraglutide is approved to improve β cell function,thus providing a new choice for treatment of type 2 diabetes.

Type 2 diabetes is a heterogeneous disorder caused by concomitant impairment of β-cell dysfunction,the hallmark of which is a series of abnormalities of histology and pathophysiology.The impairment of insulin secretion of type 2 diabetes is related to insulin deficiency and abnormal β-cell secretion.The progressive deterioration in β-cell function and mags in type 2 diabetes are the driving forces for the disease progression.

The assessment of pituitary function makes hormone replacement more timely for hypopituitarism after surgical procedure in patients with pituitary adenoma.However,there were only less than 50％ patients receiving this assessment in the current clinical practice.Only by means of the cooperation between endocrinologists and neurosurgeons and the close contact between doctors from both tertiary and primary hospitals will reach the goal of the patient-centered treatment and appropriately improve the defective therapy of the pituitary adenoma.

Objective To analyze the results of anti‐Treponema pallidum antibody (anti‐TP) in the inpatients to provide the ba‐sis for the prevention and control of syphilis .Methods The results of anti‐TP test among 50 011 patients in our hospital from Jan . 2013 to Nov .2015 were retrospectively analyzed .Results Of 50 011 detected inpatients ,1 360 cases were anti‐TP positive with the total anti‐TP positive rate of 2 .72% ,in which the male positive rate was 3 .22% (719 cases)and the female positive rate was 2 .32%(641 cases) ,the difference was statistically significant (P< 0 .05) .The neonates ,populations aged ≥80 years old and 40 - < 60 years had higher anti‐TP positive rate ,which were 3 .67% ,3 .62% and 3 .24% respectively .The inpatients with anti‐TP positive were mainly concentrated in the surgical departments ,totally 916 cases(67 .35% ) ,in which the general surgery department had the highest anti‐TP positive detection rate(20 .51% ) ,while 444 cases(32 .65% ) of anti‐TP positive were in the non‐surgical depart‐ments .Among the inpatients with anti‐TP positive ,520 cases(38 .24% ) had the positive titer in the serum TRUST .Conclusion Syphilis infection situation is serious ,the routine anti‐TP detection in inpatients has an important significance for preventing nosoco‐mial infection and reducing the medical dispute .

Objective To investigate the difference in healthcare-associated infection (HAI)status and antimicro-bial resistance of Acinetobacterbaumannii(A.baumannii)isolated from different wards,so as to provide evidence for effective prevention and therapy for HAI caused by A.baumannii.Methods Clinical data of 446 A.baumannii isolates from hospitalized patients between January 2012 and July 2013 were analyzed retrospectively. Results The majority of 446 A.baumanniiisolates were from patients admitted to intensive care unit (ICU,n= 236,52.92% ), followed by departments of respiratory diseases(n= 55,12.33% )and neurosurgery (n= 48,10.76% ),and the strains were mainly isolated from sputum specimens (94.62% ).Antimicrobial susceptibility testing with 13 kinds of commonly used antimicrobial agents showed that antimicrobial resistance of A.baumanniifrom ICU were highest, susceptibility rates were all<20% ,the next were from department of neurosurgery,susceptibility rates were all<30% ,while susceptibility rates of A.baumanniifrom department of respiratory diseases were all >50% .Conclu-sion The difference in antimicrobial resistance of A.baumanniifrom different wards varied significantly,antimi-crobial resistance of A.baumanniifrom ICU is most serious.

The syndrome of inappropriate antidiuretic hormone secretion ( SIADH ),characterized with dilutional hyponatremia,is the most frequent pathophysiology of euvolemic hyponatremia in hospital inpatients.Conventional therapies for SIADH include fluid resriction,saline infusion,and some pharmacologic adjustments of fluid balance.For various reasons,conventional therapies show poor efficiency.Vasopressin receptor antagonist,a new class of pharmacologic agent,can directly block vasopressin-mediated receptor activation and target underlying pathophysiology of SIADH.

Objective: To investigate the effect of GLP1 on the blood glucose in type 2 diabetic rats,and its protective effects on the islet B cells.Methods: Thirty rats were divided into three groups: spontaneous type 2 diabetes animal model OLETF rats,GLP-1 [from the twelfth week 56 ?g/(kg?d),sc] therapy group and LETO rats as control.In the 14th and 20th weeks,standard OGTT including fast and 2 h-plasma glucose were measured respectively.In the 14th weeks,3 rats from each group were killed randomly,and the rest of the rats were killed until the 20th week.Immunostaining with the marker of PCNA,TUNEL,and insulin assessed metabolic changes in the islet. Ultrastructure of the B cell was observed with the electronic microscope.Results: In the 14th and 20th week,AUC for insulin were higher in treated animals(10.86?1.56 vs.9.07?1.28,P

100 were found in 8,7 and 9 patients respectively.(3)The positive rate in detection of insulinoma by ultrasonography,CT scan and intraoperative palpation was 30%,60% and 100% respectively.Conclusion Typical symptoms and laboratory examinations are main evidence in diagnosis of insulinoma.Intraoperative ultrasound and palpation are more useful for localization diagnosis of insulinoma.Operations should be considered in patients with typical clinical characteristic and negative imageology.

Objective:To observe the efficacy and safety of docetaxel plus apatinib as a second-line treatment for advanced non-squa-mous non-small cell lung cancer. Methods:From February 2015 to August 2016, 39 eligible patients were randomly assigned to experi-mental arm (19 cases) and control arm (20 cases). Patients in the experimental arm received 60 mg/m2 d1 docetaxel and 500 mg d1-21 apatinib for a 21-day cycle until disease progression or unacceptable toxicity occurred. Patients in the control arm received chemother-apy only. Disease control rate (DCR), incidence of adverse event, and progression-free survival (PFS) were analyzed. Results:The dis-ease control rates (DCR) in the experimental and control arms were 63.2% and 30.0%, respectively, with statistical difference (P=0.039). The experimental arm experienced many grades 3-4 hematologic adverse events with statistical difference (P=0.032). The medi-an PFS values were 5.6 months (95% CI=4.8-6.3) and 3.0 months (95% CI=1.8-4.1) with statistical difference (P=0.04). Conclusion:Docetaxel plus apatinib can be delivered safely with careful monitoring for the treatment of advanced non-squamous non-small cell lung cancer, and this treatment can significantly improve the DCR and PFS.

Objective To evaluate the efficacy and safety ofbevacizumab combined with FOLFIRI regimen as second-line treatment in advanced colorectal cancer.Methods Sixty-five advanced colorectal cancer patients previously treated with oxaliplatin were divided into test group(33 patients) and control group (32 patients) by random digits table method.The patients in test group received bevacizumab combined with FOLFIRI regimen chemotherapy.The patients in control group received FOLFIRI regimen chemotherapy only.The therapeutic effect was evaluated every 4 cycles.Results In test group,1 patient received complete remission,9 patients had partial remission,the rate of efficacy was 30.3％ (10/33).In control group,non patient had complete remission,3 patients received partial remission,the rate of efficacy was 9.4％ (3/32).The rate of efficacy between two groups had significant difference (x2 =4.45,P =0.035).The median duration of survival was 13.0 months in test group,and 10.3 months in control group(HR =0.58,P=0.038).The median progression-free survival duration was 7.5 months in test group,and 4.4 months in control group (HR =0.45,P =0.003).The median treatment cycle was 12 cycles in test group and 8 cycles in control group.The rate of Ⅲ/Ⅳ grade adverse events in test group was higher than that in control group[72.7％(24/33) vs.46.9％ (15/32)] (P ＜ 0.05).None of these events led to death during the study.Conclusions Bevacizumab combined with FOLFIRI as second-line treatment in advanced colorectal cancer can improve the total remission rate,and prolong the progression-free survival duration and total survival duration with an acceptable adverse reaction.