Objective To observe the therapeutic effect of exenatide combined with metformin therapy in type 2 diabetes with nonalcoholic fatty liver disease.Methods 50 patients with type 2 diabetes and nonalcoholic fatty liver disease were randomly divided into experimental group and control group with 25 cases in each.The control group were treated with metformin, the experimental group were treated with exenatide on the basis of metformin.Before treatment and at the end of 12-week treatment, patients height, weight, body mass index(BMI), waistline(WC), glycated hemoglobin(HbA1c), fasting blood glucose(FBG),fasting C-peptide(FCP), triglyceride(TG), cholesterol(TCH), high density lipoprotein(HDL), low density lipoprotein(LDL),systolic pressure(SBP), diastolic pressure(DBP), alanine aminotransferase(ALT), superoxide dismutase(SOD), liver lipid contents(LFC) were detected.Results Baseline data were not significantly different between the two groups.Compared to baseline, WC, HbA1c, FBG and LFC in experimental group and control group were obviously improved after treatment(P<0.05), and the experimental group improved more significantly than control group(P<0.05).Conclusion Exenatide combined with metformin has an obvious therapeutic effect on BMI, WC, HbA1c, FBG, FCP, SBP, TG, TCH, HDL, LDL, LFC than mere metformin treatment in treatment of type 2 diabetes with nonalcoholic fatty liver disease.

Objective To evaluate the prognostic value of enhanced CURB and CURB-65 score in patients with community acquired pneumonia.Methods A retrospective study was conducted among 555 patients with community-acquired pneumonia recruited.According to the patient's 28 day outcome, they were divided into effective group(n=510, 57 cured and 453 improved) and ineffective group(n=45, 30 did not improve and 15 died).The prognosis of the two groups was evaluated using the enhanced CURB and CURB-65 score, the sensitivity and specificity of the two scoring methods were compared.Results Compared with the ineffective group, the age, length of hospital stay and the prevalence of the complications of chronic diseases were significantly lower than the effective group(P<0.05).The score of enhanced CURB and CURB-65 of ineffective group were significantly higher than the effective group(P<0.05).The sensitivity of enhanced CURB score was significantly higher than that of CURB-65 (P<0.05) while its specificity was significantly lower than that of CURB-65(P<0.05).Conclusion The CURB and CURB-65 score in community acquired pneumonia can effectively assess the severity of the disease and thus guide the treatment of patients with community acquired pneumonia.

To evaluate the visual performance of aspheric multifocal intraocular lens (SN6AD1+3. 0D) implanta-tion in age-related cataract surgery. Forty-eight patients (60 eyes) with age-related cataract were divided into two groups, 28 patients(30 eyes)in the multifocal group (implanted with SN6AD1+3. 0D multifocal intraocular lens), and 20 patients(30 eyes)in the monofocal group (implanted with SN60WF monofocal intraocular lens). The uncor-rected and the best corrected distance,intermediate and near visual acuity and the amplitude of pseudoaccommoda-tion were measured after surgery,and the subjective visual performance was evaluated by the questionnaire. The un-corrected intermediate and near visual acuity were statistically better in the multifocal group than the monofocal group. The amplitude of pseudoaccommodation of multifocal and monofocal group was (2. 65 ± 0. 48) D and (0. 38 ± 0. 15)D. The spectacle independent rates of multifocal and monofocal group were 86% and 13% respectively.

Objective To evaluate the root canal deviations in vitro teeth curved root with TF and Protaper instru-ments by cone beam computer tomography( CBCT) . Methods 40 teeth in vitro in the standard collection were ran-domly assigned to two groups, prepared with the crown-down method, the TF group ready to 0. 06/#25; the Pro-taper group ready to F2 . CBCT scans were taken to measure the mesial and distal thicknesses of the tube wall in vitro teeth before and after preparation. The root canal deviation and the rate of shaft center were measured with ref-erence to the formula proposed by Gambill. Results The TF group need less time in preparation and has more effi-ciency(P<0. 05) than the Protaper group; both TF and Protaper devices appeared deformation after 5 root canal preparations in average, no instruments broken. Comparing the offset of the internal and external wall of root canal in 3, 5, 7 mm from the apex, the root canal deviation prepared by the TF group was less than the Protaper group, and its rate of axis center was greater than the Protaper group, closer to 1. Conclusion TF can maintain original root canal morphology in preparing curved root canal, also has higher efficiency;under the noninvasive condition, the root canal forming ability of preparation instruments can be evaluated by CBCT.

This article presented a series of cases using vascularized interpositional periosteal-connective tissue ( VIP-CT) flap with guide bone regeneration ( GBR) in peri-implant soft and hard tissue reconstuction at the esthet-ic zone of maxillary. Fifteen cases with bone and soft tissue defects underwent VIP-CT flap with GBR in the implant treatment. And the attached gingiva width was evaluated before treatment and six months and eighteen months after the operation. The width of attached gingival of six months and eighteen months after surgery was significantly dif-ferent from the preoperative value (P<0. 05). However, no statistically significant difference could be found at six months and eighteen months postoperative. The application of VIP-CT flap could increase the width of attached gin-giva around implants and the short-term effects were stable and favorable.

To investigate the changes of drug resistance of pseudomonas aeruginosa ( PA) to common antimicrobial agents in recent 3 years in Anhui province. The average drug resistance rate was 15. 3%, 17. 0% for piperacillin/tazobactam, amikacin respectively, while the average resistance rate was higher for the third generation cephalospo-rin cefotaxime, ceftriaxone and ceftizoxime, which was between 42. 0% and 55. 0%. The average drug resistance rate was 25. 2% for imipenem. The resistance rates for ceftazidime, cefepime, ceftriaxone and ceftizoxime were sig-nificantly increased( P<0. 05 ) . The resistance of PA to the third generation cephalosporin and ciprofloxacin in-creased gradually, close attention should be paid to it in clinical practice.

Objective To explore the effect of smoking on the triglyceride ( TG ) , cholesterol ( TC ) , high density lipoprotein-cholesterol(HDL-C) and low density lipoprotein-cholesterol(LDL-C) with the male type 2 diabetes. Methods Selected 144 male patients with type 2 diabetes, then divided them into four groups, including non-smokers, former smokers,current mild(≤20 per day) smokers and current heavy ( >20 per day) smokers. All of them were investigated about the age, diabetes pathogenesis, exercise, diet, smoking, lipid-lowering drugs used and checked with TG, TC, HDL-C, LDL-C and so on. The difference of TG, TC, HDL-C, LDL-C among these four groups was compared by the methods of covariance analysis, regression analysis and partial correlation to evalu-ate the relationships of smoking with blood lipid. Results TG of heavy smokers was higher than the non-smokers and HDL-C was lower after correcting the effects of other possibly relative factors(P<0. 05). HDL-C of the former smokers was higher than smokers and TG was lower than heavy smokers(P<0. 05). Smoking was an independent risk factor for HDL-C ( P<0. 05 ,β= -0. 213 ) , and there was a significantly negative relationship between daily cigarette consumption and HDL-C ( r= -0. 223 , P<0. 05 ) . Conclusion Smoking is an important risk factor for the diabetic male patients’ metabolism of the TG and HDL-C,independent of age, body mass index, blood pres-sure,exercise,diabetes pathogenesis, percentage of body fat and blood glucose. Smoking promotes the type 2 diabet-ics’ disorder of blood lipid and smoking cessation is of significance for the diabetics’ regulation of blood lipids.

Six patients with lung cancer treated with therapy were included. They were retrieved the image and re-planned by fraction 10. The volume of GTV was reduced (65. 59 ± 17. 09)% after three-stage treatments. The doses of target tumor were the same in three-stage treatments. Compared with IMRT, ART1 reduced V20 , V30 , MLD of whole lung by 2. 01%,2. 66%,241. 78 cGy(P=0. 005,0. 039,0. 026). Compared with ART1,ART2 further re-duced the indexes by 3. 21%,2. 97%,288. 64 cGy(P=0. 005,0. 013,0. 046). The doses of ipsilateral lung were reduced significantly (P<0. 05). But this was not for opposite lung. The dose V50,Dmean of heart and V55 of esopha-gus were similar to each plan. Dmean of esophagus with ART1 was smaller than with IMRT(261. 98 cGy,P=0. 002) and Dmean of esophagus with ART2 was smaller than with ART1(300. 43 cGy,P=0. 008). D2% and Dmean of spinal cord were reduced in turn significantly(P<0. 05).

Objective To analyze the relationship between serum intermedin ( IMD ) , CystatinC ( CysC ) and fibro-blast growth factor23(FGF23) with hypertensive left ventricular hypertrophy (HLVH). Methods Serum IMD,Cy-sC and FGF23 levels of 30 patients with essential hypertension(EH group),30 hypertensions with LVH(HLVH group)and 30 healthy subjects(control group)were detected by enzyme-linked immunosorbent assay(ELISA). All the subjects did UCG for LVMI. Results LVMI and serum IMD,CysC,FGF23 levels were significantly higher in EH group than in control(P<0. 05),higher in HLVH group than in EH and control groups(P<0. 05). In the pa-tients with hypertension LVMI and serum IMD,CysC,FGF23 levels were increasing with increased blood pressure levels. LVMI level was positively correlated with serum IMD,CysC and FGF23 levels(r=0. 769,0. 517,0. 700;P<0. 01). Line to LVMI level as the dependent variable,multiple stepwise regression analysis showed that:systolic blood pressure( SBP) ,IMD,CysC,homocysteine( Hcy) ,FGF23 entered regression equation. They were independent risk factors for LVMI. Conclusion Serum IMD, CysC and FGF23 levels are closely associated with EH and HLVH. They may participate in the development of EH and affect the process of HLVH. Combined-detection of ser-um IMD,CysC and FGF23 can be used as a reference index for the condition and prognosis of HLVH.

Objective To explore the effect of radiofrequency catheter ablation( RFCA) on cardiac reverse remode-ling and improvement of life quality in cardiomyopathy patients with paroxysmal atrial fibrillation( PAF) . Methods 95 cardiomyopathy patients with PAF were enrolled in our study and divided into two groups. RFCA group:62 patients received circumferential pulmonary vein isolation, ( left ventricular end-diastolic ) LVEDD ≥55 mm (male), LVEDD ≥50 mm (female); Drug group:33 patients were treated with drug for controlling heart rate ( resting heart rate around 60~80 bpm, heart rate during daily activity <100 bpm) . 72 hours after admission or 6 months after surgery in RFCA group, when the heart rate returned to normal or 6 months after treatment in Drug group, Short-Form36(SF-36) was used to evaluate the quality of living in the patients respectively; transthoracic echocardiography was performed in sinus rhythm;LAD, LVEDD and LVEF of the patients were measured. Results in RFCA group, LAD and LVEDD of 62 patients reduced and LVEF increased in 6 months after surgery statisti-cally significant(P<0. 05). In Drug group, 6 months after treatment, LAD and LVEDD of 33 patients increased ( P<0. 05 ) , without significant change in LVEF. There was no statistical significance in psychological health, physical function and general health perceptions, but there was significant improvement in social function and phys-ical function,affective state, physical role and energy in both RFCA group and drug group (P<0. 05), and it was more obvious in RFCA group(P<0. 05). Conclusion RFCA can reverse cardiac structural remodeling via sinus rhythm maintenance and improve the quality of life in cardiomyopathy patients with PAF.