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.

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 .

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 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.

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.

A reninoma is a renal juxtaglomerular cell apparatus tumor that produces excessive amounts of renin,resulting in secondary hyperaldosteronism,and associated hypertension and hypokalemia.It is a rare form of secondary hypertension and occurs mainly in young adult females.Common symptoms include headache,nocturia,polyuria,polydipsia,and fatigue.Imaging examination and selective renal vein sampling has been the traditional method of localizing the tumour.The diagnosis should be considered in all patients with hypertension and hypokalemia and no evidence of primary hyperaldosteronism and renal artery stenosis.Reninoma represents a surgically correctable cause of hypertension.

Objective To investigate the clinical value of the expert type terminal of long distance electronic fetal heart rate home monitoring system in the application to self monitoring of pregnant woman at home in peripartum Methods All the pregnant women ( n =284) were divided into two groups Research group ( n = 134) contained 73 high risk gravida There were 78 high risk gravida in control group ( n =150) In the research group, self monitoring at home in 134 women was taken by the expert type terminal of long distance electronic fetal heart rate monitoring system through telephone and fetal movement counting The women were requested to auscultate and transfer fetal heart rate (FHR) to electronic FHR monitoring center in hospital Non stress test(NST) was made 1～2 times every week when fetal movement was active When women felt any abnormality of baby, she should immediately test NST and then the photograph of NST was send to FHR monitoring center by telephone Doctor would make a diagnosis and management in time according to the photograph of NST In the control group, the way of fetal monitoring was fetal movement counting and regular NST test in the outpatient clinic Results The incidence of abnormal NST was significantly higher in the research group than that in the control group (respectively 22 0% vs 13 5%, P 0 05) Conclusions The expert type terminal of long distance electronic FHR monitoring system through telephone is a new way of the FHR self monitoring at home The application of this method could ease mental press of the women, decrease significantly perinatal mortality, decrease incidence of neonatal asphyxia, and improve quality of obstetrics Whatever there are high risk factors in any pregnant women, the system should be appied to all late pregnant women

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.