Objective To investigate the clinical effect of sitagliptin combined with metformin in the treatment of sulfonylurea-deficient elderly patients with diabetes mellitus.Methods Sixty patients with diabetes mellitus were enrolled in our hospital from January 2013 to December 2016.The patients were divided into observation group(30 cases) and control group(30 cases) according to the random number method.The patients in the observation group were treated with sitagliptin and metformin.The patients in the control group were treated with gemcitabine, and the clinical treatment effect, fasting blood glucose, postprandial blood glucose, glycosylated hemoglobin, fasting C peptide and postprandial 2hC peptide Level of statistical comparison.Results The clinical effect of the observation group was significantly higher than that of the control group.Before and after treatment, the fasting blood glucose, 2h postprandial blood glucose, glycosylated hemoglobin, fasting C peptide and postprandial 2hC peptide level were not significantly different After fasting blood glucose, 2h postprandial blood glucose and glycosylated hemoglobin levels were significantly lower than before treatment, after treatment of fasting C peptide and postprandial 2hC peptide levels were significantly higher than before treatment.Conclusion The clinical efficacy of serotretine combined with metformin in the treatment of elderly patients with diabetes mellitus is similar to that of Yuxing, and the combination is more convenient and more suitable for clinical treatment.It is worthy to be popularized and applied in clinical practice.

ObjectiveTo explore the impact of autonomic nerve function on motor function in patients with post-stroke depression (PSD) from the perspective of regional homogeneity (ReHo). MethodsFrom January to December, 2020, a total of 60 inpatients and outpatients with cerebral infarction in the Affiliated Brain Hospital of Nanjing Medical University were divided into control group (n = 30) and PSD group (n = 30). Two groups were assessed using Fugl-Meyer Assessment (FMA), modified Barthel Index (MBI) and Hamilton Depression Scale (HAMD). Heart rate variability (HRV) was measured. Ten patients in each group were selected randomly to undergo resting state functional magnetic resonance imaging (rs-fMRI) to calculate ReHo. ResultsAll HRV indices were lower in PSD group than in the control group (|t| > 2.092, P < 0.05). In PSD group, FMA and MBI scores showed positive correlations with 24-hour standard deviation of normal-to-normal R-R intervals (SDNN), the root mean square of successive differences between normal heartbeats over 24 hours (RMSSD), the percentage of differences between adjacent normal R-R intervals over 24 hours that were greater than 50 ms (PNN50), total power (TP), very low frequency power (VLF) and low frequency power (LF) (r > 0.394, P < 0.05), and showed negative correlations with HAMD scores (|r| > 0.919, P < 0.001). HAMD scores in PSD group were negatively correlated with SDNN, RMSSD, PNN50, TP and VLF (|r| > 0.769, P < 0.001). Compared with the control group, the ReHo increased in PSD group in the right rectus gyrus (142 voxels, t = 6.575), the left medial and paracingulate gyri (204 voxels, t = 4.925) (GRF correction, P_-Voxel < 0.005，P_-Cluster < 0.05); and reduced in the right cerebellum (191 voxels, t = -6.487), the left middle temporal gyrus (140 voxels, t = -5.516), and the left precentral gyrus (119 voxels, t = -4.764) (GRF correction, P_-Voxel < 0.005，P_-Cluster < 0.05) in PSD group. ConclusionAutonomic nerve function is related to motor dysfunction in patients with PSD. The modulation of emotional, cognitive and motor brain regions by the autonomic nervous system may play a role in influencing the motor function in patients with PSD.