Objective:To study the efficacy and safety of saxagliptin or pioglitazone combined with metformin in the newly diag-nosed patients with type 2 diabetes mellitus(T2DM) with inadequate glycemic control by metformin alone. Methods:Totally 82 newly diagnosed T2DM patients with inadequately control by metfomin monotherapy for 12 weeks were randomly divided into two groups, sax-agliptin group ( saxagliptin combined with metforminc) and pioglitazone group ( pioglitazone combined with metformin) . The blood glu-cose control, homeostatic model assessment of insulin resistance index ( HOMA-IR) , body weight change and adverse reactions were assessed before and after the treatment for 12 weeks. Results:After the 12-week treatment,the level of fasting plasma glucose ( FPG) , two-hour postprandial plasma glucose (2hPG) and glyeosylated hemoglobin(HbA1c) in both groups were significantly decreased. Compared with the pioglitazone group,the level of 2hPG and HbAlc was lower while the level of FPG was higher in the saxagliptin group (P<0. 05). Compared with the saxagliptin group,the level of fasting plasma insulin(FINS) was significantly decreased and HOMA-IR was significantly improved in the pioglitazone group. The body mass index ( BMI) of the patients was increased in the pioglitazone group(P<0. 05) and showed no change in the saxagliptin group(P>0. 05). There was no statistical difference in the adverse reac-tions between the two groups(P>0. 05). Conclusion:The combination of saxagliptin or pioglitazone with metformin in the treatment of newly diagnosed patients with type 2 diabetes can improve glycemic control with low incidence of hypoglycemia and adverse reactions. Saxagliptin is more suitable for the patients with heart diseases or old patients.

Objective To explore the determination of nicotine in cigarettes by fluorescein and fluorimetry-basic possession of bonuses system.Methods Nicotine could interfere with fluorescence energy transfer between fluorimetry-basic possession of bonuses.A new way of energy transfer was established to determinate nicotine according to the fluorescence increment of fluorimetry.Results The linear range was 0.2-7.0 mg/L for the concentration of nicotine.The correlative coefficient was 0.9992.The detection limit was 0.18 mg/L.The recovery rates were 99.0 %-105 %,and RSDs were 1.1 %-4.8 % respectively.Conclusion This method is simple,fast,accurate and sensitive.It can be used to determinate nicotine in cigarettes.

Using human spleen purified SSA antigen,we set up a new technique of dot immunobinding assay(DIBA)for detection of anti—SSA antibody.The specificity of DIBA is better than that of double immunodiffusion method.The positive rate of anti—SSA antibody in Sjogren syndrome is 76.9%,while that in systemic lupus erythematosus is 33.3%.We found that anti—SSA antibody and RF usually appeared in same patient with Sjo-gren syndrome or rheumatoid arthritis.

In order to acquire the information on the changes and improvement after the implementation of National Schistosomiasis Control and Prevention Regulation, a survey was performed. The awareness of schistosomiasis and the regulation, stool management and other related contents were carried out in the rural areas of Jiangsu, Anhui, Jiangxi, Hubei, Hunan, Sichuan and Yunan provinces. The results showed 98.9% of the residents knew about schistosomiasis, 89. 8% knew the regulation, 95. 1% supported the management of drinking water and lavatory, 45.3% used tap water as their ordinary drinking water supply, but there were 47.6% still drank well water, 51.1% used water closet and 40.0% used simple toilet. The work on improving water and sanitary conditions in mountain areas was left behind that in lake areas. It is indicated that there is still a lot we must do to promote the propaganda of the regulation.

Objective The effect of intermittent iron supplementation weekly and twice weekly was studied in children with iron deficiency anemia(IDA). Methods Subjects were 58 children who were randomly divided into two groups. One group received a dosage of 2mg/kg Fe every 3d for 9 weeks. The other group received the same dose Fe once a week for 12 weeks. Results Hemoglobin and serum ferritin increased significantly after treatment in both groups (P ＜0.05), and zinc protoporphyrin decreased significantly (P ＜0. 05). But serum ferritin of both groups was different after 6 weeks of treatment (P ＜0. 01). The side effect of the group supplemented once every 3d was higher than that of the group once a week, but there was no statistically significant difference. Conclusion Iron sup plementation every 3d has a similar effect to once a week for treatment of IDA. The former should be used for the se rious patients for 6 weeks. The later should be used for infants and the patients whose resistance of intestines and stomach are not good.

Objectives To summarize and analyze the characteristics ofspina bifida occulta in prenatal ultrasound scan in order to improve the accuracy of diagnosis.Methods Sixteen singleton pregnant women with fetal spina bifida occulta who were diagnosed in the Ultrasonography Department of Dalian Maternal and Child Health Hospital from January 2014 to April 2015,were enrolled in this study.Diagnosis was made based upon the abnormalities found in the spinal column of fetus during routine ultrasound scan,followed by a close examination on the fetal spinal column and the position of conus medullaris by using multiple scan.Descriptive analysis was used to summarize the characteristics of spina bifida occulta in ultrasonic images.Results Among the 16 cases,12 had subcutaneous mass (nine cases had follicle-like anechoic mass and three cases had masses with strong echoes).The other four cases without subcutaneous mass manifested signs of disappeared physiological curvatures or disordered arrangement of spinal column,angulation deformity or scoliosis,or asymmetry in ossification centers of spinal column on both sides of lesions and lowered position of conus medullaris.Lemon shaped head and banana shaped cerebellum were seen in one case,while the other 15 cases were found no cerebral abnormalities.Eight cases had tethered cord (the position of conus medullaris was lower than the second lumber vertebra),six cases had unclear position of conus medullaris and the other two were normal.Diagnoses for all of the 16 cases were confirmed by MRI after delivery or autopsy or neonatal operation.Conclusions Abnormalities such as subcutaneous mass and tethered cord observed in prenatal ultrasound scan are significant indicators for suspected closed spinal dysraphism and further multiple scan is required to confirm the diagnosis.

Objective: To explore the personality traits, emotions, and cognitive factors related to the trends of computer game addiction and cyber-relationship addiction. Methods: 184 college students in Beijing filled up the following questionnaires, including Computer Game Addiction Inventory (CGAI), Internet Relationship Addiction Inventory (IRDI), Sensation Seeking Scale (SSS), Achievement Motivation Scale, Self-Esteem Scale (SES), Shame Scale, Beck Depression Inventory (BDI), Eysenck Personality Questionnaire-R Short Scale(EPQ-RSC), and cognition questionnaire developed by the authors. Results: ① The trend of computer game addiction was positively correlated with sensation seeking, achievement motivation, the negative evaluation on oneself and environment in inter-personal relationships, and the positive evaluation on one's intelligence (P

Objective To investigate demography of sensory tricks in cervical dystonia (CD),and to discuss the relationship between sensory tricks and the function of sensorimotor integration of cerebral cortex,meanwhile to explore potential worthiness using sensory tricks in the management of CD.Methods We recruited 75 patients (23 male,52 female,male female ratio:1:2.26;aged 19-72 years,mean (42.45 ± 13.09) years) admitted to the Dystonia Clinic Center of the First Affiliated Hospital of Dalian Medical University from March 2016 to April 2013.Standardized questionnaire on sensory tricks was used to investigate the sensory tricks first recognized in 75 patients retrospectively.Median nerve somatosensory evoked potential via multipoint recording was measured in 43 CD patients who manifested as simple rotation of neck.Bilateral amplitudes of P22/N30 derived from F (3,4) were compared.Results Frequency of sensory tricks in CD was 85.53％ (64/75) in our research.As disease progressed,the type of sensory tricks used by patients may transform from one to another or even disappear.No statistically significant differences were found in ages among patients using classic sensory tricks,forcible tricks and patients without sensory tricks,whereas the complexity of the disease showed increased tendency among the three groups.Bilateral P22/N30 amplitudes of patients with classic sensory tricks showed no significant differences.P22/N30 amplitudes contralateral to the head turn were significantly higher than ipsilateral in patients using forcible tricks ((3.16 ± 1.71) μV vs (2.47 ± 1.28) μV,t =2.243,P=0.038) and patients without sensory tricks ((3.62 ±1.58) μV vs (2.73 ±1.14) μV,t=2.893,P=0.023).Tsui scores among patients using classic sensory tricks (9.36 ± 3.52) and forcible tricks (12.67 ± 5.00) or patients without sensory tricks (15.18 ± 4.07) had statistically significant differences (classic sensory tricks vs forcible tricks,t =-3.020,P =0.004;classic sensory tricks vs patients without sensory tricks,t =-4.452,P =0.000).Conclusions Types of sensory tricks used by patients are associated with severity of the disease.Different types of sensory tricks may reflect status of adaptive compensatory mechanism of the cerebral cortex.

Objective To observe the efficacy of self-made Arnebiae oil by our hospital on phaseⅠandⅡpressure ulcers. Methods A total of 324 pressure wounds of 283 cases collected from March 2014 to August 2015 were randomly divided into the observation group (145 cases) and the control group (138 cases). The control group received Kangfuxin solution in conjunction with conventional pressure ulcer care treatment, the observation group were treated with Arnebiae oil and conventional pressure ulcer care treatment. The therapeutic effect and healing time of both groups were compared. Results Arnebiae oil was effective in 96.97% (160/165) of the pressure ulcer patients and cured 84.85% (140/165) patients in the observation group. Nearly 84.91%(135/159) patients were effective and 50.94%(81/159) patients were cured in the control group. There was statistical significance (χ2=42.93, 14.46, P<0.01). The healing time was (8.78±4.27) d in the observation group and (10.46±3.99) d in the control group with significance(t=2.88, P< 0.05). The healing rates of Arnebiae oil sacrococcygeal region, hips, legs and other parts were 87.96%(95/108), 9/10, 12/16, 9/9, significantly higher than those of the control group, 46.43%(39/84), 6/12, 3/9, 9/15, the difference had statistical significance (χ2=4.02-44.35, P<0.05). Conclusion Arnebiae oil com-bined with the overall care can improve the rate of wound healing in aged pressure ulcer, which is suitable for clinical application.

Objective To investigate the effect of folic acid combined with Helicobacter pylori (Hp) eradication therapy on chronic atrophic gastritis.Methods From December 2009 to March 2011 at the First Affiliated Hospital of Nanjing Medical University,184 patients with endoscopic and pathological diagnosis of chronic atrophic gastritis (90 Hp positive and 94 Hp negative) were selected.Hp positive patients were divided into group A and group B.Forty-three patients in group A were treated with standard triple Hp eradication therapy and follow by folic acid therapy for three months.Forty-seven patients in group B and Hp negative patients received three months of folic acid therapy.The clinical symptoms of each group were scored before treatment,one month after folie acid therapy and three months after folic acid therapy and analyzed by t test. Patients of each group received gastroscopy before treatment and three months after medicine withdrawal. Endoscopic scores,pathological scores and t test were recorded.The serum levels of pepsinogen ( Ⅰ,Ⅱ ) and gastrin 17 in venous blood of 55 Hp negative patients were detected by enzyme-linked immunosorbent assay (ELISA) method before treatment and three months after medicine withdrawal.Results Compared with three months therapy (1.15 ± 0.03),after one month folic acid therapy (1.55 ± 0.04) was statistically significant in clinical symptoms score of all patients (t =8.18,P＜0.01).By the end of therapy,clinical symptom score of group A (1.06 ± 0.04) was lower than that of group B (1.56 ±0.08),and the difference was significant (t=6.00,P＜0.01).There was significant difference in endoscopic scores of all patients between before treatment (1.57±0.95) and after treatment (1.00±0.76,t=11.12,P＜0.01).The differences in each pathological score of all patients (inflammatory scoring,active scoring,atrophy scoring,intestinal metaplasia scoring,atypical hyperplasia degree scoring) were significant between before treatment and after treatment (t=5.51,6.90,7.53,6.34,2.90,respectively,all P＜0.01).The serum level of pepsinogen Ⅰ before treatment of 55 Hp negative patients [(1.03±0.19) nmol/L] was lower than that after treatment [(2.24±0.33) nmol/L],and the difference was statistically significant (t=3.19,P＜0.01).After treatment the level of gastrin 17 [(0.86±0.05) nmol/L] was higher than that before treatment [(0.47±0.05) nmol/L],and the difference was statistically significant ( t =5.33,P＜ 0.01 ).Conclusion Folic acid in combination with Hp eradication therapy can be favorable to atrophic gastritis,which may promote the secretion of pepsinogen and gastrin.