Objective: To investigate the effects of exenatide on body weight, blood glucose, blood lipids and proteinuria in obese and overweight young and middle-aged patients with type 2 diabetes to provide reference for better controlling the macro-vascular and micro-vascular complications in the patients.Methods: Totally 60 obese and overweight young and middle-aged patients with poorly controlled type 2 diabetes were chosen and randomly divided into exenatide group and novolin N group with 30 ones in each.The patients maintained the previous oral hypoglycemic drugs, and exenatide group was treated with exenatide, Novolin N group was treated with protamine biosynthetie human insulin(NovolinN), and the treatment course was 3 months.The body weight, BMI, fasting plasma glucose (FPG), 2-hour postprandial blood glucose (2hPG), glycated hemoglobin (HbA1C), fasting C-peptide (FCP), 2-hour postprandial C-peptide (2hCP), blood lipids, plasma homocysteine (HCY) and urine microalbumin (UMA) were compared before and after the treatment.Results: After 3 month treatment,the FPG,zhpG and HbAlc were significantly decreased both in exenatide group and NwoCinN group(P<0.05),and were no significant differences.were found in these parameters between the two groups(P>0.05).In exenatide group, the levels of FCP and 2hCP were higher than those before the treatment (P<0.05), and the body weight, BMI, TG and UMA were significantly lower than those before the treatment (P<0.05).However, in Novolin N group, all the above-mentioned indices were not significantly changed after the treatment (P>0.05).Conclusion: Exenatide can effectively control blood glucose, improve β-cell function, reduce body weight, lower blood lipids and decrease urine protein.

Objective To evaluate the clinical value of full-field digital mammography three-dimensional (3D) positioning system for localization and excision of nonpalpable breast lesions.Methods 106 patients with nonpalpable breast lesions and underwent preoperative localization were analyzed retrospectively.They underwent wire-localization operation guided by mammography 3D positioning system (GE Senogrphe DS).The depth of wire insertion was calculated manually and automatically.Combined with the manual measurement, systematic measurement, skin elasticity and breast parenchyma structure, the positioning wire was placed.Then, the clinical resection was performed according to the wire localization.Results The localization accuracy of mammography 3D positioning system was 100%.11 patients appearedsyncope.With the rest, psychological comfort and fluid infusion, patients recovered quickly.Conclusion Full-field digital mammography 3D positioning system can improve the accuracy of clinical resection of nonpalpable breast lesion.

Objective: To investigate the effect of exenatide on body weight, blood glucose, blood lipids, insulin resistance and the degree of fatty liver in young and middle-aged patients with type 2 diabetes and non-alcoholic fatty liver disease (NAFLD). Meth-ods: Totally 70 young and middle-aged patients with poorly controlled type 2 diabetes and NAFLD were chosen and randomly divided into observation group and the control group with 35 cases in each group. The patients were treated with exenatide or isophane prota-mine biosynthetic human insulin injection for 3 months on the basis of original oral hypoglycemic drugs. The body weight, BMI, waist circumference, HOMA-IR, plasma glucose (FPG), 2 hour postprandial blood glucose (2hPG), glycated hemoglobin (HbAlc), blood lipids, liver function indices (ALT, AST and GGT), and the severity of fatty liver were compared before and after the treatment. Re-sults: After the 3-month treatment, there was no significant difference in glycemic control between observation group and the control group. After treatment, the body weight, BMI, waist circumference, HOMA-IR, TG, ALT, AST and GGT in observation were signifi-cantly decreased than those before the treatment(P<0. 05), and were superion to those in control group(P<0. 05). While in the control group, all the above indices were not significantly changed before and after the treatment (P>0. 05). The total efficiency for treating NAFLD in observation group was significantly higher than that in the control group (P<0. 05). Conclusion: Besides reducing blood glucose effectively, exenatide can also obviously reduce body weight and TG level, improve insulin resistance, decrease liver en-zymes, and significantly ameliorate the degree of fatty liver. The results suggested that exenatide might be a new therapeutic option for young and middle-aged patients with type 2 diabetes and NAFLD.

Objective:To explore the effect of solution-focused brief therapy (SFBT) on negative emotions such as anxiety and depression in patients with ulcerative colitis.Methods:From April 2018 to December 2019, a total of 160 patients with ulcerative colitis who met inclusion criteria were randomly divided into a control group and an experimental group and underwent psychological interventions. We employed conventional psychological interventions for the control group and solution-focused brief therapy for the experimental group. The Hamilton Anxiety Scale (HAMA) and the Hamilton Depression Scale (HAMD) were used to evaluate post-intervention effects.Results:Before intervention, there were no statistically significant differences in patient demographics, treatment plans, anxiety scores, or depression scores between the two groups of patients. After intervention, the HAMA score of the experimental group was (10.91±8.96) points, which was statistically significantly lower than the control group (12.73±7.98) points ( t value was 5.099, P<0.05). The HAMD score of the patients in the experimental group was (12.02±9.21) points, which was statistically significantly lower than the control group (14.85±8.91) points ( t value was 4.856, P<0.05). Conclusion:Solution-focused brief therapy may be a better approach than traditional psychological intervention methods to manage anxiety, depression, and other negative emotions in patients with ulcerative colitis.

OBJECTIVE: To analyze the clinical characters and treatment of nasopharyngeal tuberculosis, and to provide a scientific basis for improving clinical diagnosis of nasopharyngeal tuberculosis. METHOD: The clinical materials of 50 patients diagnosed as nasopharyngeal tuberculosis in Guangzhou Chest Hospital were reviewed and analyzed. All the 50 patients were given regular antituberculosis treatment with 3HRZS(E)/9HR(E) for one year, and were treated through nasal spray with combination medication of isoniazid, rifampicin and streptomycin injection solution for 3 months. RESULT: All patients were cured through regular antituberculosis treatment for one year, and no recrudescence cases were found in 2 years of follow-up. CONCLUSION Nasopharyngeal tuberculosis is rare and the clinical manifestation is atypical. It is extremely easy to cause clinical misdiagnosis. A full understanding of the pathogenesis, timely clinical characters under nasopharyngoscope and histopathological examination results are the keys to diagnosis, and to giving regular antituberculosis treatment to obtain satisfactory curative effect.
Adolescent ; Adult ; Aged ; Antitubercular Agents ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Nasopharyngeal Diseases ; diagnosis ; drug therapy ; microbiology ; Tuberculosis ; diagnosis ; drug therapy ; Young Adult

The newly emerged Middle East respiratory syndrome coronavirus (MERS-CoV) is a highly pathogenic respiratory virus with pathogenic mechanisms that may be driven by innate immune pathways. The goal of this study is to characterize the expression of the structural (S, E, M, N) and accessory (ORF 3, ORF 4a, ORF 4b, ORF 5) proteins of MERS-CoV and to determine whether any of these proteins acts as an interferon antagonist. Individual structural and accessory protein-coding plasmids with an N-terminal HA tag were constructed and transiently transfected into cells, and their native expression and subcellular localization were assessed using Wes tern blotting and indirect immunofluorescence. While ORF 4b demonstrated majorly nuclear localization, all of the other proteins demonstrated cytoplasmic localization. In addition, for the first time, our experiments revealed that the M, ORF 4a, ORF 4b, and ORF 5 proteins are potent interferon antagonists. Further examination revealed that the ORF 4a protein of MERS-CoV has the most potential to counteract the antiviral effects of IFN via the inhibition of both the interferon production (IFN-β promoter activity, IRF-3/7 and NF-κB activation) and ISRE promoter element signaling pathways. Together, our results provide new insights into the function and pathogenic role of the structural and accessory proteins of MERS-CoV.
Cell Line ; Coronavirus ; genetics ; pathogenicity ; Genes, Viral ; Humans ; Interferons ; antagonists & inhibitors ; Open Reading Frames ; Recombinant Proteins ; genetics ; metabolism ; Viral Matrix Proteins ; genetics ; metabolism ; Viral Regulatory and Accessory Proteins ; genetics ; metabolism ; Viral Structural Proteins ; genetics ; metabolism

Objective: To explore the characteristics of thrombelastogaphy (TEG) in term neonates, and to evaluate their correlation with traditional coagulation tests. Methods: A total of 52 term neonates were enrolled as neonatal group and 34 adults undergoing elective surgery as adult control group in Jiangmen Central Hospital from January to December 2017.TEG, plasma coagulation test and platelet counts (PLT) were performed and the corresponding ana-lysis was conducted. Results: TEG parameters in term neonates: response time(R)(4.18±1.08)min, clot kinetics(K)(1.21±0.45) min, α angle (Angle)(73.08±5.74)°, maximum amplitude(MA)(65.68±7.13)mm.Compared with adult control group, neonatal group exhibited shorter R and K(t=3.764, P<0.001; t=4.888, P<0.001), higher Angle, MA(t=5.539, P<0.001; t=2.873, P=0.001). In traditional coagulation, compared with adult control group, neonatal group showed longer prothrombin time(PT), activated partial thromboplastin time(APTT), thrombin time(TT) (t=5.449, P<0.001; t=13.134, P<0.001; t=3.575, P=0.001), lower fibrinogen(Fib) (t=4.164, P<0.001), and higher PLT (t=4.230, P<0.001). In addition, K was negatively correlated with Fib(r=-0.374, P=0.004), while Angle and MA were positively correlated with Fib(r=0.354, P=0.007; r=0.630, P<0.001); K was negatively correlated with PLT(r=-0.430, P=0.001), but Angle and MA were positively correlated with PLT (r=0.427, P=0.001; r=0.586, P<0.001); K was positively correlated with APTT(r=0.285, P=0.035), and MA was negatively correlated with APTT(r=-0.324, P=0.017). There was no significant correlation between R and traditional coagulation test.K, MA and Angle were not significantly correlated with PT (all P>0.05), and Angle and APTT were not significantly correlated (all P>0.05). Conclusions The reference interval of TEG in term neonates is different from adults.And the parameters of TEG in term neonates are partly related to the traditional coagulation tests.

Objective To observe the value of CT"cut-edge sign"for differentiating complex thymic cyst and thymic epithelial tumor(TET)with diameter less than 4 cm.Methods Data of 24 patients with complex thymic cyst(complex thymic cyst group)and 14 patients with TET(TET group)confirmed by surgical pathology who underwent plain and dual-phase enhanced chest CT scanning were retrospectively analyzed.CT"cut-edge sign"was evaluated by 2 physicians,and the inter-observer consistency was evaluated using intra-class correlation coefficient(ICC).The detection rate of CT"cut-edge sign"was compared between groups using logistic regression analysis.Receiver operating characteristic(ROC)curve was drawn,and the area under the curve(AUC)was calculated to evaluate the efficacy of CT"cut-edge sign"for differentiating complex thymic cyst and TET.Results The inter-observer consistency of CT"cut-edge sign"was good(ICC=0.94,95％CI[0.90,0.97]).The detection rate of CT"cut-edge sign"in complex thymic cyst group was 62.50％(15/24),higher than in TET group(2/14,14.29％)(P＜0.01).The sensitivity,specificity,accuracy and AUC of CT"cut-edge sign"for differentiating complex thymic cyst and TET was 62.50％(15/24),85.71％(12/14),71.05％(27/38)and 0.74,respectively.Conclusion CT"cut-edge sign"was helpful for differentiating complex thymic cyst and TET with diameter less than 4 cm.

Objective:To evaluate the immunogenicity of a novel influenza virus mRNA vaccine based on conserved antigens delivered by lipopolyplex (LPP) platform in a mouse model.Methods:Four copies of genes coding for extracellular domain of matrix 2 protein (M2e) and nucleoprotein (NP) of influenza A virus were synthetized after codon optimization. The fusion antigens were transcribed in vitro and delivered by LPP platform, named as LPP-4M2eNP. Expression of M2e and NP in eukaryotic cells was detected by immunofluorescence assay (IFA). BALB/c mice were inoculated intramuscularly twice with 10 μg or 30 μg LPP-4M2eNP vaccine at an interval of four weeks. Antibody response was detected by ELISA and cellular-mediated immunity (CMI) was detected by enzyme-linked immunospot assay (ELISPOT). Results:IFA showed that NP and M2e were expressed correctly in eukaryotic cells. Single dose immunization could induce significant antigen (NP, M2e)-specific CMI and antigen (NP, M2e)-specific antibody response was induced in mice with Th1 type bias after boost immunization. Moreover, NP-specific CMI was increased significantly after the second immunization, while no significant change in M2e-specific CMI was observed.Conclusions:Stronger CMI was triggered in mice by single dose of LPP-4M2eNP vaccine. Furthermore, robust humoral and cellular immune responses were induced after boost immunization. This study suggested that LPP-4M2eNP vaccine, which based on conserved antigen of influenza A and delivered by LPP platform, had great potential for development and application.

OBJECTIVE: To investigate the survival of patients with cardiac arrest and cardiopulmonary resuscitation (CA-CPR), and to analyze the factors influencing survival at 30 days after restoration of spontaneous circulation (ROSC). METHODS: A retrospective cohort study was conducted. Clinical data of 538 patients with CA-CPR admitted to the People's Hospital of Ningxia Hui Autonomous Region from January 2013 to September 2020 were enrolled. The gender, age, underlying disease, cause of CA, type of CA, initial rhythm, presence or absence of endotracheal intubation, defibrillation, use of epinephrine, and 30-day survival rate of patients were collected. The etiology of CA and 30-day survival rate among patients with different ages were compared, as well as the clinical data between patients who survived and died at 30 days after ROSC were also compared. Multivariate Logistic regression was used to analyze the relevant factors affecting the 30-day survival rate of patients. RESULTS: Among 538 patients with CA-CPR, 67 patients with incomplete information were excluded, and 471 patients were enrolled. Among 471 patients, 299 were males and 172 were females. Aged from 0 to 96 years old, 23 patients (4.9%) were < 18 years old, 205 patients (43.5%) were 18 to 64 years old, and 243 patients (51.6%) were ≥ 65 years old. 302 cases (64.1%) achieved ROSC, and 46 patients (9.8%) survived for more than 30 days. The 30-day survival rate of patients aged < 18 years old, 18-64 years old and ≥ 65 years old was 8.7% (2/23), 12.7% (26/205) and 7.4% (18/243), respectively. The main causes of CA in patients younger than 18 years were severe pneumonia (13.1%, 3/23), respiratory failure (13.1%, 3/23), and trauma (13.1%, 3/23). The main causes were acute myocardial infarction (AMI; 24.9%, 51/205), respiratory failure (9.8%, 20/205), and hypoxic brain injury (9.8%, 20/205) in patients aged 18-64 years old, and AMI (24.3%, 59/243) and respiratory failure (13.6%, 33/243) in patients aged ≥ 65 years old. Univariate analysis results revealed that the 30-day survival rate of patients with CA-CPR may be related to the the cause of CA was AMI, initial rhythm was ventricular tachycardia/ventricular fibrillation, endotracheal intubation and epinephrine. Multivariate Logistic regression analysis results showed that CA was caused by AMI [odds ratio (OR) = 0.395, 95% confidence interval (95%CI) was 0.194-0.808, P = 0.011] and endotracheal intubation (OR = 0.423, 95%CI was 0.204-0.877, P = 0.021) was a protective factor for 30 days of survival after ROSC in patients with CA-CPR. CONCLUSIONS The 30-day survival rate of CA-CPR patients was 9.8%. The 30-day survival rate of CA-CPR patients with AMI after ROSC is higher than that of patients with other CA causes, and early endotracheal intubation can improve the prognosis of patients.
Female ; Male ; Humans ; Infant, Newborn ; Infant ; Child, Preschool ; Child ; Adolescent ; Young Adult ; Adult ; Middle Aged ; Aged ; Aged, 80 and over ; Retrospective Studies ; Survival Rate ; Heart Arrest ; Hospitals ; Epinephrine ; Ventricular Fibrillation