Objective To evaluate the clinical effects of sitagliptin and sitagliptin combined with glimepiride in the treatment of type 2 diabetes (T2DM).Methods Ninety-two patients with T2DM were randomly divided into sitagliptin group (group J),glimepiride group (group G) and sitagliptin combined with glimepiride group (group U),group J took sitagliptin,group G took glimepiride,group U took sitagliptin and glimepiride.Before and after treatments,blood glucose and insulin were determined in the fasting and 2-hour blood samples after taking glucose (fasting blood-glucose (FPG),2-hour postprandial blood glucose (2hPG),insulin (FIns),2-hour postprandial insulin (2hIns),and glycosylation hemoglobin (HBA1 c) were also determined and homeostasis model assessment was applied to estimate the functions index of islet β cell(HOMA-β).Results The levels of blood glucose and HBA1C in three groups decreased after treatments(FPG,(before treatment:(9.2±3.0),(9.2±2.8),(9.3±3.2) mmol/L),(after treatment:(7.7 ± 3.0),(6.9 ± 2.6),(6.0 ± 2.5) mmol/L),and t values are 2.205,3.203,3.691,P ＜ 0.01,P ＜ 0.05 ;2 hPG (before treatment:(14.1 ± 5.7),(14.8 ±6.3),(15.0±6.8) mmol/L),(after treatment:(7.9 ±2.9),(9.0 ±3.1),(7.1 ±3.1) mmol/L),and t values are 3.881,3.159,4.189,P ＜ 0.01 ; HBA1c (before treatment:(8.52 ± 2.01)％,(8.48 ± 1.94)％,(8.56 ±2.27)％,(after treatment:(7.64 ± 1.92)％,(6.81 ± 1.55)％,(6.19 ± 1.84)％),t values are 2.292,2.184,3.269,P ＜ 0.01,P ＜ 0.05) ; HOMA-β in the three groups increased after treatment ((before treatment:1.42 ± 0.07,1.44 ± 0.06,1.41 ± 0.11),(after treatment:1.76 ± 0.14,1.68 ± 0.20,1.85 ±0.17),t values are 2.180,2.073,2.882,P ＜ 0.01,P ＜ 0.05);levels of HBA1c and blood glucose in group U were lower than those in group J and G(HBA1 c:t values are 2.785,2.138,P ＜ 0.05,P ＜ 0.01 ;FPG:t values are 2.252,2.346,P ＜0.05;2hPG:t values are 2.147,2.829,P ＜0.01,P ＜0.05),HOMA-β in which was higher than that of group G(t =2.153,P ＜ 0.05),but with no significant difference compared with group J (t =1.796,P ＞ 0.05),levels of HBA1C,FPG and HOMA-β in group J were higher than those of group G (t values are 2.108,2.202,2.121,P ＜ 0.05),level of 2hPG of group J was lower than that of group G(t =2.307,P ＜ 0.05).Conclusion Sitagliptin provides significant glycaemic control,together with glimepiride,clinical effect of treatment of type 2 diabetes will be enhanced.

Objective To analyze tumor-free survival rate and recurrence rate of radiofrequency ablation (RFA) versus surgical resection(SR) for small hepatocellular carcinoma. Methods Clinical data of 64 patients (hospitalized from October 2008 to October 2010) with small hepatocellular carcinoma(≤ 5 cm) in our hospital were retrospectively analyzed. 29 cases among them underwent RFA, and the 35 cases underwent SR, then they were further divided into two groups according to the tumor diameter (≤ 3 cm vs. ≤ 3 ~ 5 cm). The rate of complete elimination of tumor , complications , recurrence and metastasis , and survival rate out of tumor-free at year 1, 3, and 5 were compared. Accumulated survival rate of the two groups at year 1, 3, and 5 were compared. Results The rate of complete elimination of tumor, and complications in the RFA group were 89.66% and 6.9% respectively, and no statistically significant difference was found compared with the SR group (100% and 14.29%, respectively) . The rate of recurrence and metastasis and 1, 3, 5- year tumor-free rate in RFA and SR group with tumor diameter < 3 cm were 60.00%, 80.00%, 40.00%, 30.00% and 38.46%, 84.62%, 61.54%, 38.46% (P > 0.05) respectively, and for the cases with tumor diameter in 3 ~ 5 cm, these data showed no significant difference between groups (P > 0.05). No significant difference were found in tumor-free survival rate within groups, while rate of recurrence and metastasis was significantly lower in the < 3 cm group (P < 0.05). The accumulated survival rate in RFA at year 1, 3 and 5 were 100%, 62.07%, 37.93% and 100%, 62.86%, 48.57% in SR group (P > 0.05). Conclusions RFA and SR had similar medium and long term clinical effect for small hepatocellular carcinoma with tumor diameter≤ 5 cm. The larger in size of the tumor, the higher rate of recurrence and metastasis. RFA is less invasive and can avoid complications and should be considered an eligible treatment for small hepatocellular carcinoma with tumor diameter ≤ 5 cm.

Objectives: To clarify the diagnostic value of sTFR and its compound parameters sTFR/SF, sTFR/logSF in the differential diagnosis of IDA, ACD and CDID. Methods: Forty nine anemia patients were classified into IDA, ACD and CDID by clinical presentations and the laboratory results. The serum concentration of sTFR was detected by ELISA. The difference of sTFR, sTFR/SF, sTFR/logSF and routine parameters in the three groups and the correlation among sTFR and routine parameters were analyzed. Using ROC curve, the diagnostic value of these parameters in the differential diagnosis of the three diseases were compared. Results: The serum concentration of sTFR in the IDA, ACD and CDID were (50.8?8.2)nmol/L, (33.5?6.9)nmol/L and (22.7?9.9)nmol/L,respectively. The differences among three groups were significant( P

OBJECTIVE: To explore the clinical effect of arthroscopic combined with small needle knife in the treatment of degenerative medial meniscus (MM) injury of knee joint by releasing the superficial layer of medial collateral ligament (SMCL). METHODS: From February 2016 to November 2018, 56 patients (56 knees) with limited pain, strangulation and flexion in medial knee joint space were selected. X-ray Kellgren-Lawrence grading was I-II. MRI showed medial meniscus injury(III degree) of knee joint. There were 30 males(30 knees) and 26 females(26 knees). Arthroscopic MM plasty and small needle knife were used to release SMCL. The Lysholm knee score was used to evaluate the effect of operation. RESULTS: All 56 patients were followed up, and the duration ranged from 3 to 24 months, with an average of 10 months. According to the Lysholm knee score standard, the final follow-up was compared with that of before operation. The results showed that the preoperative knee score was 37.24±1.32, the latest follow-up knee score was 85.72±5.28, the knee score was higher than that before the operation(<0.05). CONCLUSIONS Arthroscopy combined with small needle knife release of superficial medial collateral ligament in the treatment of degenerative medial knee meniscus injury can effectively improve the mechanical balance of the knee joint, improve Lysholm knee score in patients with knee meniscus injury, and promote the recovery of knee joint function, which has clinical value.
Arthroscopy ; Collateral Ligaments ; Female ; Humans ; Knee Joint ; Male ; Medial Collateral Ligament, Knee ; Menisci, Tibial ; Treatment Outcome

Objective To study the safety and efficacy of ultrasound-guided puncture combined with surgical resection for liquefied cavitary hepatic alveolar echinococcosis (HAE).Methods A retrospective study was conducted on 17 patients who had liquefied cavitary HAE and were treated at the Affiliated Hospital of Qinghai University from January 2014 to August 2016.Ten patients were treated with ultrasound-guided puncture combined with surgical resection (the case group),and 7 patients were treated with resection (the control group).The basic characteristics,operation time,blood loss during operation,preoperative and postoperative laboratory tests and complications were compared between the 2 groups.Results There were no significant differences between the 2 groups in basic characteristics,such as age,gender,and lesion diameter (P ＞ 0.05).The operation time and blood loss during operation showed significant differences between the 2 groups,(308.0 ± 23.0) min (389.0 ± 95.7) min and (1 360.0 ± 182.9) ml vs.(1 607.1 ± 205.0) ml,respectively (all P ＜ 0.05).The prothrombin time (PT) after day 3 of operation and alanine aminotransferase level after day 5 of operation showed significant differences between the 2 groups,(13.8 ±0.9) s vs.(15.5 ±1.7) s and (81.9 ±20.9) U/L vs.(108.1 ±29.5) U/L,respectively (all P ＜ 0.05).There was no significant difference in postoperative complications between the 2 groups.Conclusions Ultrasound-guided puncture combined with surgical resection shortened the operation time,reduced blood loss and avoided serious complications after surgery.This treatment is efficacious and safe for liquefied cavitary HAE.

Abstract OBJECTIVE To explore the efficacy and safety of triptorelin in the treatment of central precocious puberty in girls. METHODS A total of 49 girls with central precocious puberty who were treated at Haining People's Hospital's pediatric endocrinology clinic from January 2020 to August 2022 were included in this study. These patients were treated with triptorelin according to standardized protocols and followed up for at least one year. The therapeutic efficacy and safety were analyzed and compared before treatment, after 6 months of treatment, and after 12 months of treatment. RESULTS After 6 and 12 months of treatment, there were no significant changes in uterine and ovarian volume, but both showed a reduction compared to before treatment. The Tanner stage of breast development decreased after treatment, and the luteinzing hormone levels measured by a simple stimulation test decreased compared to before treatment. Body mass index gradually increased, while bone age/chronology age ratio gradually decreased. These differences between the time points were statistically significant(P<0.05). The growth rate was highest in the first 3 months of treatment, and then gradually decreased in some patients. Three cases experienced minor vaginal bleeding after treatment. Additionally, parents expressed concerns about the use of growth hormone due to drug adverse reactions. CONCLUSION Triptorelin effectively suppresses the hypothalamic- pituitary-gonadal axis and delays skeletal maturation in girls with central precocious puberty. Apart from some cases of decreased growth rate and minor vaginal bleeding, adverse reactions are minimal during treatment.

Objective:To evaluate the curative effect of 3D printing titanium trabecular metal （TTM） acetabular cups in revision of total hip arthroplasty （THA）.Methods:A retrospective case series study was conducted on the clinical data of 24 patients （25 hips） undergoing THA revision in Affiliated Hospital of Qingdao University from May 2016 to September 2019. There were 10 males and 14 females，aged 43-78 years ［（63.0 ± 11.4） years］. According to Paprosky classification，5 patients（5 hips） were classified as type Ⅰ，9 patients （10 hips） as type ⅡA，5 patients （5 hips） as type ⅡB，1 patient （1 hip） as type ⅡC and 4 patients （4 hips） as type ⅢC. All patients used 3D printing TTM cups. Seven patients （7 hips） were combined with 3D printing TTM pads，and 3 patients （3 hips） were combined with structural bone grafts. The visual analogue scale （VAS），Harris score and quality of life Health Survey Scale （SF-36） score were evaluated before operation，3 months after operation，12 months after operation and at the last follow-up. The X-ray film of hip joint was performed to evaluate the upward movement distance of hip center of rotation （HCOR），limb-length discrepancy （LLD） before operation，1 day after operation and at the last follow-up. The position of cups and bone ingrowth were evaluated at the last follow-up. The postoperative complications were observed.Results:All patients were followed up for 14-54 months ［（34.2 ± 9.3）months］. The VAS was （4.0 ± 0.7）points，（2.3 ± 0.8）points and （0.9 ± 0.2）points at postoperative 3 months，12 months and the last follow-up，significantly lower than that preoperatively ［（6.1 ± 1.0）points］ （ P < 0.05）. A statistically significant difference was found in the pairwise comparisons of postoperative VAS at postoperative 3 months，12 months and the last follow-up（ P < 0.05）. The Harris score was （64.6 ± 5.3）points，（80.5 ± 3.7）points，and （90.3 ± 3.6）points at postoperative 3 months，12 months and the last follow-up，significantly higher than that preoperatively ［（38.8 ± 6.2）points］ （ P < 0.05）. A statistically significant difference was found in the pairwise comparisons of postoperative Harris score at postoperative 3 months，12 months and the last follow-up（ P < 0.05）. The SF-36 score was （556.3 ± 21.9）points，（711.6 ± 15.9）points and （752.8 ± 23.0）points at postoperative 3 months，12 months and the last follow-up，significantly higher than that preoperatively ［（326.3 ± 30.7）points］ （ P < 0.05）. A statistically significant difference was found in the pairwise comparisons of postoperative SF-36 score at postoperative 3 months，12 months and the last follow-up（ P < 0.05）. The upward movement distance of HCOR was （13.5 ± 2.6）mm and （13.6 ± 2.6）mm on the first day after operation and at the last follow-up，significantly lower than that preoperatively ［（34.1 ± 3.5）mm］ （ P < 0.05）. The LLD was （6.2 ± 1.8）mm and （5.3 ± 1.5）mm on the first day after operation and at the last follow-up，significantly lower than that preoperatively ［（31.6 ± 5.2）mm］ （ P < 0.05）. All the cups were stable. Good bone ingrowth was found in 23 hips. There was no postoperative complication except for one patient with poor wound healing. Conclusion:For THA revision，the use of 3D printing TTM cups can effectively relieve pain，improve hip function，provide satisfactory biological fixation and and reduce complications.

Objective:To investigate the repair effect of electrospun gelatin polycaprolactone (GT/PCL) nanofiber aerogels (NFA) combined with cartilage extracellular matrix (ECM) for treatment of cartilage injuries in rabbits.Methods:Firstly, the GT/PCL electrospun membrane was prepared by electrospinning and was ground into the short fiber at high speed. ECM was extracted and separated from fresh bovine articular cartilage, which mixed with the short fiber solution (10 ∶1). Subsequently, it was used to prepared GT/PCL/ECM (NFA) three-dimensional scaffold. Finally, the physical characteristics of the three different scaffolds (GT/PCL, ECM and GT/PCL/ECM) were detected by scanning electron microscope and Fourier-transform infrared (FTIR) spectrometer, including the composition, microstructure, swelling rate, porosity, compressive strength and degradation rates. And the biocompatibility research was getting on by co-culturing the scaffold with chondrocytes. Fifteen male New Zealand white rabbits were divided into blank control group (Group A, n=5), ECM group (group B, n=5) and composite scaffold(GT/PCL/ECM)group (Group C, n=5) according to the random number table. An injury model was established and three types of bio-scaffold materials were implanted into different groups. At 3 weeks, the cartilage repair was evaluated among groups by semi quantitative global MRI scoring system (WORMS). After the animals were killed, the knee joints of each group were scored by the international society for cartilage repair histological score (ICRs); the ICRs histological score was performedby HE staining and safranine green staining. Results:Three scaffolds showed a porous three-dimensional structure under the scanning electron microscope. FIRT showed that GT and PCL were introduced into the scaffolds successfully. The GT/PCL NAF was loose and unable to be characterized by materials science. The swelling rate of GT/PCL/ECM scaffold [(1, 092.0±32.2)%] was higher than that of ECM scaffold [(933.6±16.3)%] ( P<0.01). The porosity of GT/PCL/ECM scaffold [(92.3±2.3)%] was higher than that of ECM scaffold [(85.9±2.2)%] ( P<0.05). The compressive strength of ECM scaffold [(2.7±0.1)kPa] and of GT/PCL/ECM scaffold [(2.4±0.1)kPa] showed no statistical difference ( P>0.05). The degradation rate of ECM scaffold was higher than that of GT/PCL/ECM scaffold, but the difference was not statistically significant ( P>0.05). The cytotoxicity rating of GT/PCL/ECM scaffold was grade I, indicating that its biocompatibility was better. At 3 weeks, the MRI WORMS score in Group C [(49.0±11.4)points] was significantly higher than that in Group B [(40.0±6.7)points] and that in Group A [(24.0±6.5) points] ( P<0.05 or 0.01); the general ICRS score of group C was [(7.4±1.1) points], which was significantly higher than that of group B [(4.6±1.1)points] and group A [(3.0±1.2)points] ( P<0.01); The ICRS histological scores of group C and group B were [(6.8±0.8)points] and [(4.2±0.8)points] respectively compared with group A [(2.8±0.8)points] were significantly higher ( P<0.05 or 0.01). Conclusion:GT/PCL/ECM (NFA) scaffold has similar tissue structure to natural cartilage and is superior to traditional ECM scaffold in physical properties and biocompatibility, which provides a stable environment for chondrocyte adhesion and growth, promotes collagen regeneration, and thus accelerates the repair of cartilage injury.

This study was performed to investigate a potential marker for the presence of spermatozoa in the ejaculate following varicocelectomy in Chinese men with nonobstructive azoospermia and varicoceles. The micro-RNA (miR)-192a levels in seminal plasma and testicular tissue were evaluated by quantitative real-time polymerase chain reaction from 60 men with nonobstructive azoospermia and varicoceles (Group A: 27 men with spermatozoa found in the ejaculate after surgery; Group B: 33 men without spermatozoa found in the ejaculate after surgery) and 30 controls. The seminal plasma and testicular tissue miR-192a levels were higher in Group B than in Group A and the controls (P < 0.001), and there was no significant difference between Group A and the controls (P > 0.05). Apoptosis and proliferation assays with miR mimics and inhibitors showed that miR-192a induced GC-2 cell apoptosis through the activation of Caspase-3 protein. Thus, seminal plasma miR-192a appears to be a potential marker for successfully indicating spermatozoa in the ejaculate following microsurgical varicocelectomy in men with nonobstructive azoospermia and varicoceles. Seminal plasma miR-192a may be a useful clinical marker for prescreening to determine which patients with nonobstructive azoospermia and varicoceles would benefit from varicocelectomy.
Adult ; Apoptosis ; Asian People ; Azoospermia/surgery* ; Biomarkers/analysis* ; Caspase 3/analysis* ; Cell Proliferation ; Humans ; Infertility, Male/etiology* ; Male ; MicroRNAs/biosynthesis* ; Microsurgery ; Predictive Value of Tests ; Semen/metabolism* ; Testis/metabolism* ; Treatment Outcome ; Varicocele/surgery*

The composition of serum is extremely complex,which complicates the discovery of new pharmaco-dynamic biomarkers via serum proteome for disease prediction and diagnosis.Recently,nanoparticles have been reported to efficiently reduce the proportion of high-abundance proteins and enrich low-abundance proteins in serum.Here,we synthesized a silica-coated iron oxide nanoparticle and devel-oped a highly efficient and reproducible protein corona(PC)-based proteomic analysis strategy to improve the range of serum proteomic analysis.We identified 1,070 proteins with a median coefficient of variation of 12.56％using PC-based proteomic analysis,which was twice the number of proteins iden-tified by direct digestion.There were also more biological processes enriched with these proteins.We applied this strategy to identify more pharmacodynamic biomarkers on collagen-induced arthritis(CIA)rat model treated with methotrexate(MTX).The bioinformatic results indicated that 485 differentially expressed proteins(DEPs)were found in CIA rats,of which 323 DEPs recovered to near normal levels after treatment with MTX.This strategy can not only help enhance our understanding of the mechanisms of disease and drug action through serum proteomics studies,but also provide more pharmacodynamic biomarkers for disease prediction,diagnosis,and treatment.