Objective To compare the clinical effects and safety of treating newly diagnosed type 2 diabetes patients by combining Glargine insulin with Metformin or/and Acarbose. Methods 84 patients with newly diagnosed type 2 diabetes ,who have a history of weight loss, body mass index( BMI )23 ～ 28kg/m2 and poorly controlled blood glucose in Metformin at least a month ,were randomly divided into three groups. Glargine insulin plus Mefformin were used in group A. Glargine insulin plus Acarbose(without mefformin)were used in group B, Glargine insulin, Acarbos and metformin were used in Group C. All three groups were given a 12-week follow-up. Results FBG,2hBG and HbA1c levels were lower in the patients after treatment( P ＜0. 05 ). HbA1c of patients was partly up to the standard in group A and group B,but HbA1c of patients was all up to the standard in group C. The effects in group C were better than those in group A and group B. It had the shortest time to achieve the target and the smallest dose of insulin in group C. BMI in group A and B did not change but decreased in group C(P＞0.05).The incidence of low blood sugar in all three groups was low and no significant difference observed among three groups (P＞0.05). And in all three groups no severe hypoglycemia occurred. Conclusion The method of combining Glargine insulin with Mefformin or/and Acarbose could effectively control blood sugar had little impact on body weight of the newly diagnosed type 2 diabetes patients, and moreover, the incidence of low blood sugar in the newly diagnosed type 2 diabetes patients was lower. It would be the ideal method to treat newly diagnosed type 2 diabetes patients considering the general safety and effectiveness and convenience.

ObjectiveTo investigate the morning blood pressure surge(MBPS) and its relationship with 24-hour blood pressure variability and anti-hypertensive drugs in middle-aged and elderly hypertensive patients.Methods A total of 521 middle-age and elderly men were surveyed with ambulatory blood pressure monitoring and ambulatory electrocardiograms recordings as well as questionnaire investigation from January 2009 to December 2010.Subjects were divided into MBPS positive group and MBPS negative group according to the level of MBPS[ ＞35 mm Hg (1 mm Hg=0.133 kPa) or ≤35 mm Hg].ResultsIn all the cases,the prevalence of MBPS was 19.4％,of which the elderly and very elderly had higher prevalences ( 18.9％ and 21.8％,respectively) than the middle-aged (5.6％,both P ＜0.01 ).Significant differences could be found in age [ ( 81.6 ± 6.4 ) years vs ( 78.7 ± 9.7 ) years ],day mean systolic blood pressure [ ( 132.8 ± 13.3) mm Hg vs ( 128.8 ±13.3) mm Hg],fasting blood glucose [ (5.96 ± 1.59) mmol/L vs (5.68 ± 1.22) mmol/L] and 24-hour blood pressure variability between the two groups ( all P ＜ 0.05 ).Significant difference could be observed in the prevalence of MBPS between the diuretics-taking group and non-taking group (27.4％ vs 17.6％,P ＜0.05 ).ConclusionsThe elderly hypertensive patients are prone to appear MBPS phenomenon.Fasting blood glucose level,24-hour blood pressure variability may be associated with MBPS.Diuretic antihypertensive treatment may not be conductive for MBPS control.

Objective By population survey,to explore the epidemiological characteristics of gastric precancerous lesions in Lishui District of Nanjing and provide objective basis for the prevention and treatment of early gastric cancer.Methods From July 2021 to December 2022,21 977 patients who received endoscopy and/or 13C-UBT in Lishui District People's Hospital and 6 medical community units in Nanjing City were retrospectively analyzed for demography characteristics,detection rate of gastric precancerous lesions,and H.Pylori infection rate.Results(1)590 cases of gastric precancerous lesions were detected(detection rate 2.68%);(2)The total detection rate of precancerous lesions and three pathological types in males were all higher than those in females(all P<0.001);(3)The minimum age for the total detection rate of precancerous lesions in males and the mini-mum age for each pathological type were lower than in females(P<0.001,0.009,0.005,0.002);(4)The popu-lation total H.pylori infection rate was 23.10%,the H.pylori infection rate in patients with precancerous lesions was higher than that in non-precancerous lesions(P<0.001),both H.pylori infection rate of male and female in precancerous lesions were all higher than those of non-precancerous lesions of the same sex(all P<0.001),in addition,the H.pylori infection rate of male whether in precancerous or non-precancerous lesions was higher than that of female(all P<0.001);(5)The precancerous lesions detection rate in male,female,and the overall age range of 20～29 to 70～79 years is positively correlated with age growth(P<0.001),and rapidly decreases after the age of 79,the of H.pylori infection rate was also positively correlated with age growth(P<0.001),and the trend of age change(P<0.001)was parallel to the precancerous lesions detection rate.Conclusions The detec-tion rate of gastric precancerous lesions in this region is above the average level in China;the total H.pylori infec-tion rate is at a relatively low level in China;the H.pylori infection rate is parallel to the age trend of the detection rate of gastric precancerous lesions,and increases with age.

To investigate the protective effects of P2X7 receptor (P2X7R) inhibitor against cerebral ischemia/reperfusion (I/R) injury in rats and the possible mechanisms.
 Methods: The neurological deficit of rats was evaluated by Longa score. The infarct volume was examined by 2, 3, 5-triphenyltetrazolium chloride (TTC) staining. The expression levels of extracellular signal-regulated kinase (ERK), phosphorylation extracellular signal-regulated kinas p-ERK), connexin 43 (Cx43), Bax, Bcl-2 and cleaved caspase-3 were detected by Western blot.
 Results: Compared with sham group, the neurobehavioral score (P<0.05) and cerebral infarct volume (P<0.01) of rats in I/R group was increased. Compared with I/R group, brilliant blue G (BBG, the antagonist of P2X7R) or PD98059 (the inhibitor of EKR kinase) could reduce the neurobehavioral score (P<0.01) and cerebral infarct volume significantly (P<0.05). The neurobehavioral score and cerebral infarct volume was further decreased (P<0.05) when rats were treated with both BBG and PD98059. Compared with I/R group, the expression levels of p-ERK, Cx43, cleaved caspase-3 and the ratio of Bax/Bcl-2 were decreased by BBG or PD98059 pretreatment, and the protective effects were further enhanced when rats were treated with both BBG and PD98059 (P<0.05).
 Conclusion: Inhibition of P2X7R reduces the cerebral I/R injury of rats. ERK inhibition is probably involved in the protective effects of P2X7R inhibitor against cerebral I/R injury, which may be related to the reduction of Cx43 and cleaved caspase-3, and the ratio of Bax/Bcl-2.
Animals ; Brain Ischemia ; drug therapy ; prevention & control ; Gene Expression Regulation ; drug effects ; Phosphorylation ; drug effects ; Purinergic P2X Receptor Antagonists ; pharmacology ; therapeutic use ; Rats ; Receptors, Purinergic P2X7 ; Reperfusion Injury ; drug therapy ; prevention & control