Objective To evaluate the curative effect of insulin glargine plus acarbose in the treatment of elderly type 2 diabetes and cerebral infarction.Methods Totally 84 elderly patients with type 2 diabetes and cerebral infarction were received insulin glargine and acarbose for 16 weeks.The levels of fasting plasma glucose (FPG),hemoglobin A1c (HbA1c),Postprandial glucose values of 2 h (2 hPG),Postprandial C peptide (PCP) and Fasting C peptide (FCP) before and after treatment were detected.Results Compared with pretreatment,the levels of FPG,HbA1c and 2 hPG after treatment were decreased to (6.87 1.46) mmol/L (t =1.658,P＜0.05),(6.48±1.12)％ (t=1.629,P＜0.05) and (8.34±2.15) mmol/L (t=2.037,P＜0.05),respectively,while PCP and FCP were increased to (3.82±0.22) μg/L and (3.52±0.36) μg/L (t=2.698,t=2.087,bothP＜0.05).Conclusions Combined insulin glargine with acarbose in the treatment of elderly type 2 diabetes and cerebral infarction can effectively reduce fasting and postprandial blood glucose,and improve the function of islet β cells.

Objective To explore the value of carbon nanoparticles in patients with papillary thyroid carcinoma (PTC) undergoing total thyroidectomy combined with ipsilateral central lymph node dissection.Methods 43 patients with unilateral PTC were retrospectively analyzed.All patients underwent total thyroidectomy combined with central lymph node dissection.Patients were divided into carbon nanoparticles group and the control group according to whether carbon nanoparticles were used in the operation.The operation time,postoperative hospitalization time,the serum calcium level and its rate of change,the parathyroid hormone and its rate of change on the 1 st day after surgery,the number of central lymph node and the transfer rate,and the postoperative complications were compared between the 2 groups.Results There was no statistical difference between the 2 groups in operation time(P ＞ 0.05),while the postoperative hospitalization time of the carbon nanoparticles group was shorter than that of the control group(P ＜ 0.05).The serum calcium and the parathyroid hormone on the 1 st day after surgery in the carbon nanoparticles group was (2.31 ± 0.13) mmol/L and (33.45 ± 14.37) pg/ml respectively,higher than those of the control group (P ＜ 0.05).The low blood calcium rate (3/20 (15％)),the temporary hypoparathyroidism rate (2/20 (10％)) and the decline degree of parathyroid hormone (47.3 ± 14.31)％ in the carbon nanoparticles group were lower than those of the control group(P ＜0.05).The number of central lymph node dissected (9.45 ± 2.33) pieces/case in the carbon nanoparticles group was more than that of the control group (P ＜ 0.05).The number of lymph node in the right recurrent laryngeal nerve (3.12 ± 0.65) pieces/case was more than that of the control group(P ＜ 0.05).The lymph node metastasis rate had no significant difference between the 2 groups(P ＞ 0.05).The incidence of postoperative complications in the carbon nanoparticles group was lower than that of the control group (P ＜ 0.05).Conclusion The application of carbon nanoparticles in total thyroidectomy combined with central lymph node dissection can contribute to the recognition and protection of parathyroid glands and its blood supply,improve the rate of central lymph node dissection,and reduce the incidence of postoperative complications.

Objectiv e:To investigate the effect of different culture conditions on the differentiation of Treg and Th17 to lay a foundation for exploring the methods to reverse the immune tolerance induced by tumor microenvironment.Methods:The IL-6 gene was cloned and stablely transferred into the tumor cell line expressing TGF-β.The conditioned mediums ( CM) were prepared by collecting the culture supernatants of tumor cell lines with or without IL-6 expression and used in the in vitro culture of peripheral blood mononuclear cells ( PBMC ) .The changes of Treg and Th17 in PBMC treated with different CM were detected with flow cytometry ( FCM) .Results:The expression of TGF-βin BEL-7402 was higher than that in HepG2.Thus the BEL-7402 was selected for preparation of cell line stablely transfected with IL -6 gene.ELISA detection confirmed the effective expression of IL -6 by the identified cell lines.It was showed that the Treg increased in PBMC treated with culture supernatants of tumor cells .However,the presence of IL-6 reversed the increase of Treg and promoted the differentiation of Th 17.Conclusion: The culture supernatants of tumor cells increases the proportion of Treg.However,the presence of IL-6 in this CM can reverse the increase of Treg and raise the proportion of Th 17.

Objective To study the effect of microRNA-204 (miR-204) on the biological characteristics of breast cancer cells.Methods Real-time PCR was used to detect the expression of miR-204 in human breast cancer cell MDA-MB-231 after transfection of miR-204 mimics and inhibitor for 48 h.Flow cytometry was used to analyse the effect of miR-204 on the proliferation and apoptosis of MDA-MB-231 cells.The effect of miR-204 on the migration of MDA-MB-231 cells was detected by Transwell migration assay.Results Real-time PCR analysis showed that miR-204 mimics and inhibitors had significant effect compared with normal control group(P<0.01).Flow cytometry analysis showed that compared with normal control group,the number of G1 phase cells of miR-204 mimics group was significantly decreased(P<0.01),while the number of G2/M cells of miR-204 mimics group was significantly increased(P<0.01).In contrast,the number of G1 phase cells of miR-204 inhibitor group was significantly increased(P<0.01),while the number of G2/M cells of miR-204 inhibitor group was significantly decreased(P<0.01).miR-204 mimics group significantly promoted apoptosis,while the inhibitor group significantly inhibited apoptosis(P<0.01).Transwell migration analysis showed that the number of cells of miR-204 mimics group were significantly reduced,while the number of cells was significantly increased in the inhibitor group(P<0.01).Conclusion We find miR-204,which can promote cell apoptosis and inhibit cell proliferation and migration,is a negative factor in the breast cancer cell line MDA-MB-231.

Objective To explore the metabolism and chronic complication features of type 2 diabetes mellitus patients with hyperferritemia. Methods:A total of 268 type 2 diabetic patients with a disease course of more than 5 years, who were hospitalized in our hospital between January to December 2019 were included in this retrospective study. Serum ferritin was measured by Chemiluminescence in each participant. Patients with other diseases, which might affect serum ferritin level, were excluded. According to the results of serum ferritin, the patients were divided into hyperferritemia group ( n=115) and normal ferritin group ( n=153). The metabolic indexes, including C-reactive protein, blood glucose, blood lipid, liver and kidney function, were measured. Chronic complications and comorbidities, including diabetic retinopathy, urinary microalbumin excretion, hypertension, coronary heart disease and cerebrovascular disease were evaluated. The correlation between hyperferritemia and various variables was analyzed. Results:Body mass index, the levels of serum urea nitrogen, uric acid, C-reactive protein, alanine aminotransferase and γ-glutamyltranspeptidase, as well as prevalence of diabetic retinopathy, microalbuminuria, hypertension and coronary heart disease, were significantly higher in hyperferritemia group than in normal ferritin group (all P<0.05). Hyperferrinemia was positively correlated with C-reactive protein ( r=0.262, P<0.001), coronary heart disease ( r=0.232, P<0.001), alanine transpeptidase ( r=0.216, P<0.001), urea nitrogen ( r=0.201, P=0.001), diabetic retinopathy ( r=0.169, P=0.008) and microalbuminuria ( r=0.176, P=0.004). Multivariate logistic regression analysis showed that hyperferrinemia was an independent risk factor of coronary heart disease and diabetic retinopathy ( OR=2.246, 95% CI 1.310-3.849, P=0.003; OR=2.232, 95% CI 1.287-3.870, P=0.004, respectively) in this patient cohort. Stepwise linear regression showed that there was a significant correlation between hyperferrinemia and microalbuminuria (β=0.165, P=0.009). Conclusions:Our results show that the level of serum C-reactive protein, alanine aminotransferase, γ-glutamyltranspeptidase, urea nitrogen, uric acid and microalbuminuria are significantly increased and the risk of coronary heart disease and diabetic retinopathy are higher in type 2 diabetic patients with hyperferritemia.

Objective:To explore the effects of feedback teaching based on dynamic cases on teaching quality of practice nurses in the department of neurosurgery.Methods:A total of 69 practice nurses from the Department of Neurosurgery in the First Affiliated Hospital of Nanjing Medical University were enrolled as the research subjects between January 2019 and August 2020, of which 33 practice nurses between January and October 2019 were selected as the control group and the other 36 practice nurses between November 2019 and August 2020 were selected as the observation group. The control group used routine teaching, while the observation group adopted feedback teaching based on dynamic cases. The assessment scores, practice effect, nursing job satisfaction, and the incidence of nursing errors after teaching were compared between the two groups. SPSS 24.0 was used for Chi-square test and t-test. Results:After teaching, the scores of each assessment (teaching rounds, health education, specialist nursing operations, morning questions, basic operations, and theoretical assessment) in the observation group were significantly higher than those in the control group, and the scores of disease change recognition ability, independent work ability, communication ability and teamwork ability were significantly higher than those in the control group ( P<0.05). After 1 week, 2 weeks, 3 weeks and 4 weeks of teaching, the teaching satisfaction in the observation group was significantly higher than that in the control group ( P<0.05). The total incidence of nursing errors in the observation group 2.78%(1/36) was significantly lower than that in the control group 27.27(9/33)( P<0.05). Conclusion:Feedback teaching based on dynamic cases can effectively improve the teaching quality of practice nurses in the department of neurosurgery, improve nursing job satisfaction, and reduce the risk of nursing errors.

A total of 820 patients who visited Endocrinology department in our hospital were enrolled in the study from June 2016 to May 2018. These patients were divided into diabetic retinopathy ( DR ) and non-diabetic retinopathy ( NDR) groups according to the occurrence of DR. Factors such as gender, age, course of diabetes, smoking/drinking history, family history of diabetes, and onset age of diabetes were compared between the two groups, and logistic regression was used to analyze the risk factors of DR. The results showed that there were 387 smoker( 47. 2％) and 433 non-smoker ( 52. 8％) in 820 tyge 2 diabetic patients, and 339 ( 41. 3％) patients were diagnosed with DR. There were no statistical differences in gender, age, body mass index, family history of diabetes, drinking history, and HbA1C between the two groups. Logistic regression analysis showed that duration of diabetes (OR=2.653,P<0.001), hypertension(OR=1.371,P=0.041),onset age of diabetes<40years(OR=1.526,P=0.028) , and adolescent smoking history( OR=2.178,P<0.001) were independent risk factors for DR.