Objective:To evaluate the clinical efficacy and safety of repaglinide and gliclazide in the treatment of elderly type 2 di-abetes mellitus (T2DM). Methods:A total of 225 T2DM patients with the age over 60 were enrolled and randomly divided into repa-glinide group (n=112) and gliclazide group (n=113). The repaglinide group was given repaglinide 0. 5~2 mg, po, tid, while the gliclazide group was given gliclazide modified release tablets 30~120 mg, po, qd,both with the treatment course of 12 weeks. The level of FPG, 2h PG, HbAlC, TC and TG and the side effects were observed and the clinical efficacy was compared between the two groups. Results:The level of FPG, 2h PG, HbAlc and TC in the two groups showed significant decrease after the treatment (P<0. 01 or P<0. 05), and the level of 2h PG was decreased more significantly in the repaglinide group (P<0. 05). There were no significant differ-ences in the total effective rate (91. 8% vs 86. 2%), hypoglycemia incidence (4. 5% vs 8. 2%) and ADR incidence (6. 4% vs 10. 1%) in the two groups (P>0. 05). Conclusion:Both repaglinide and gliclazide show safe and reliable efficacy in the treatment of elderly T2DM.

Objective To study the effect of labeling esophageal carcinoma with sliver clips on two sides by esophagoscopy in mapping the target for conformal radiotherapy (CRT). Methods Eighty patients with esophageal carcinoma (28 patients in early stage, 52 patients in late stage), who were eligible for CRT, were collected and the tumor volume was detected by three methods: CT (A),CT combined with X-ray (B) and CT combined with sliver clip labeling by esophagoscopy (C). The differences of the tumor length and position in head-foot site (Y-axsis) among three methods were compared. Results The comparison of average length of tumor in early stage patients showed significant difference among three methods in all types of tumor (F= 4.07 ～ 7.43, P＜0.05 ) except papillary type (F= 1. 71, P＞0. 05). There was difference (ranged from 0. 5 cm to 2. 0 cm) in detection of position in head-foot site between A and B methods and C method. Significant difference was found in determining the displacement on head-foot site among three methods (F = 34. 36 ～193.50,P ＜0.01). The comparison of average length of tumor in middle or terminal stage patients showed significant difference among three methods in all types of tumor (F=4. 07～30.10 ,P＜0.05) except mushroom type (F = 2.44, P＞ 0. 05). Significant difference was found in determining the displacement on head-foot site among three methods (F= 12.00 ～ 21.16, P ＜ 0. 01 ). Conclusion These findings indicate that C method is more sensitive and correct in mapping the target for CRT in comparison with other two methods.

ObjectiveTo investigate the histological features, clinical presentation, treatment and prognosis of small cell carcinoma of the prostate.MethodsThe clinical, pathological and follow-up data of two cases of small cell carcinoma of the prostate were respectively analyzed, and the related literature was reviewed.ResultsTwo cases of small cell carcinoma were diagnosed by transtectal prostate biopsy. Microscopically, the tumor arranged in nest structures and exhibited small round cells with the nuclei extremely hyperchromatic and scanty. Coagulated necrosis was easily observed. The immunohistochemical testing was positive for NSE and negative for PSA 、PAP. Case 1 received palliative surgery and postoperative chemotherapy of EP (VP-16, Cisplatin), and died of recurrence and distant metastasis after six months. Case 2 received palliative surgery and oral bicalutamide treatment, and died of recurrence and liver metastasis after three months.ConclusionsSmall cell carcinoma of the prostate has the biological behavior of invasive growth with an unfavorable prognosis, which is often in an advanced stage at first diagnosis. The ultimate diagnosis depends on histopathology and surgery combined with systemic chemotherapy and radiotherapy is the most effective treatment.

Objective To observe the effect of treating Diabetic Peripheral Neuropathy with Acupoint Injection. Methods 65 patient with DPN were randomly recruited into a control group and a treatment group after adjusting stage. The control group was treated with acupuncture, while the treatment group was treated with the Safflower inoculation fluid acupuncture point injects. Nerve function parameter (MDNS、 NCV) and clinical symptoms were observed after 3 therapeutic courses. Results Nerve function parameter (MDNS、 NCV) and clinical symptoms in the treatment group were apparently improved after treatment (P<0.05) . Conclusion Acupuncture point injected with Safflower inoculation fluid may improve clinical symptoms and nerve functions of DPN patients.

Objective:To construct a short hairpin RNA(shRNA) eukaryotic expression vector of the survivin gene,and investigate its inhibitory effect on the survivin expression in human cervical cancer cells.Methods:We designed and synthesized 2 pairs of survivin-specific small interfering RNA primers(s1 and s2),cloned them into the eukaryotic expression vector pSilencer 2.1-U6 neo by DNA recombined techniques after annealing connection reaction,and transfected them respectively into human cervical cancer cell line HeLa using LipofectAMINE2000 after identificationby restrict endonuclease digestion and DNA sequencing.Then we selected the positive clones by G418 and detected the expression of survivin mRNA by semi-quantitative RT-PCR and that of the survivin protein by Western blot.Results:The survivin shRNA eukaryotic expression vectors pSilencer2.1-s1 and pSilencer2.1-s2 were successfully constructed.Positive clones were obtained by screening with G418 for 24 days,the survivin expression in HeLa cells decreased in different degrees after transfected with pSilencer2.1-s1 and pSilencer2.1-s2,and the latter showed a better interference efficiency.Conclusion:The shRNA eukaryotic expression vector of the survivin gene we constructed,with its improved interfering efficiency,has paved the way for further research on its role in regulating the biological behavior of cervical cancer cells.

To observe the relationship between positive rate of β1-adrenergic and AT1 receptors autoantibodies with serum concentration of cystatin C in 371 patients with diabetic nephropathy patients,107 patients with type 2 diabetes,and 47 subjects as healthy control.In patients with diabetic nephropathy,the positive rates of the β1 and AT1 receptors autoantibodies were significantly higher than those in patients with type 2 diabetes and normal controls.The titers of β1 and AT1 receptors autoantibodies in diabetic nephropathy patients with abnormal cystatin C were significantly higher than those with normal cystatin C concentration.These findings suggested that β1 and AT1 receptors autoantibodie may play important roles in the pathogenesis of diabetic nephropathy.

Objective To investigate the executive function of the patients with first-episode schizophrenia,and their relationships with the positive and negative symptoms. And to evaluate the activation characteristics of prefrontal cortex(PFC) in the schizophrenia. Methods Near-infrared spectroscopy(NIRS) was used to assess the activation of the bilateral PFCs during the computerized version of Tower of London(TOL) tasks in schizophrenia and controls. The Positive and Negative Syndrome Scale(PANSS) was used to assess the psychiatric symptoms of the schizophrenia. 40 schizophrenic patients and 40 age- and gender-matched healthy subjects participated in this study. Results ( 1 ) The number of correct TOL responses in patients ( one-move ( 7.35 ± 1. 94 ), two-move ( 7.30 ± 2.53 ), three-move ( 6.58 ± 2.53 ), four-move ( 2.90 ± 1.89 ) ) was significantly less than the healthy controls( one-move (8.82 ± 1.48 ), two-move ( 8.38 ± 1.59 ), three-move ( 7.68 ± 1.47 ), four-move ( 3.73 ±1.71 ); P＜0. 05 ). ( 2 ) There was a significant negative correlation between the patients' task performance and the negative symptom scores(P ＜ 0.05 ). (3) The majority of the prefrontal area was activated in health subjects.Patients were characterized by significant decreased activation in the left PFC during the TOL task compared to healthy subjects. Conclusion Schizophrenic patients have executive function disorder at the initial stage of the disease.The results support that schizophrenia patients have hypofrontality ,and executive function is significantly negatively correlated with negative symptoms. NIRS my be a useful tool for research and clinical assessment for major psychoses.

Objective To investigate the technical requirements for the 3.0T multi-modal quantitative MR imaging of the rabbit liver.Methods A total of 8 rabbits were scanned and T1 mapping,T2 mapping,MT and Gd EOB-DTPA dynamic enhancement images were acquired.For the dynamic enhanced scanning,injecting contrast medium was followed by saline flush with different combinations of injection flow rate (1.5 mL/s and 2 mL/s) and injection volume(6 mL and 8 mL).The quality of the images was assessed and analyzed statistically.Results The total scanning time was about 20-25 min.High-quality images were acquired by T1 mapping,T2 mapping and MT sequences.There was no significant difference in image quality among different groups in Gd-EOB-DTPA dynamic enhanced scanning(P＞0.05).Two rabbits died when the combination of injection flow rate of 2 mL/s and injection volume of 8 mL was used.Conclusion 3.0 T multi-modal quantitative MR scanning of rabbit liver can be achieved successfully if scanning parameters are properly chosen.

Objective: To investigate the peak time and peak area of elements in cadmium telluride quantum dots (CdTe QDs) using size exclusion chromatography-high-performance liquid chromatography-inductively coupled plasma mass spectrometry, as well as the biological stability of CdTe QDs in vivo and in vitro. Methods: Transmission electron microscope and ultraviolet fluorescence were used for characterization and synthesis of water-soluble CdTe QDs, and CdTe QDs were added to double-distilled water, mobile phase, or bovine serum medium to observe the change in stability after different periods of time. CdTe QDs were injected into the vein of mice, and the changes in the morphology of CdTe QDs in serum and the liver were measured at 1, 24, and 72 hours after exposure. Size exclusion chromatography-high-performance liquid chromatography was used for the elution of the compounds in the solution based on their volume, and then inductively coupled plasma mass spectrometry was performed for the eluent. The flow time of ¹¹⁴Cd and ¹³⁰Te and molar ratio were used for qualitative analysis of CdTe QDs, and the peak area was used to judge whether CdTe QDs were degraded. Results: CdTe QDs were diluted to a concentration of 0.5 mmol/L with double-distilled water and then placed in a dark place at room temperature; CdTe QDs were completely degraded after 60 minutes. CdTe QDs were diluted to a concentration of 0.005 mmol/L with a mobile phase, and the peak of CdTe QDs was not detected. After CdTe QDs were placed in a dark place at room temperature for 48 hours at a concentration of 0.005 mmol/L in bovine serum mediumin vitro, the peak area of ¹¹⁴Cd was 6179841-7346084, and the peak area of ¹³⁰Te was 1077913-1191066. CdTe QDs had the highest peak area at 1 hour after exposure, and the peak areas of ¹¹⁴Cd and ¹³⁰Te were 18183894 and 25187987, respectively. CdTe QDs were quickly degraded in the liver; at 1 hour after exposure, the degradation products of CdTe QDs containing Cd were observed in liver tissue homogenate, and CdTe QDs were largely degradedat 24 hours. Conclusion This method can be used to investigate the biological stability of CdTe QDs. CdTe QDs are degraded in the liver and produce Cd²⁺, which may cause toxic reaction.

Objective:To evaluate the value of ultrasonography in evaluating the influential factors of early insufficient flow after central venous catheter placement in dialysis patients.Methods:Three hundred and twenty seven hemodialysis patients who underwent central venous catheterization at the Affiliated Hospital of Chengde Medical College from May 2016 to June 2019 were selected. According to the catheter flow, the patients were divided into the low catheter flow group(43 cases) and the normal catheter flow group(284 cases). The distribution variance of clinical features(age, gender, blood pressure) were compared and whether some ultrasonic parameters(position of catheter tip, left ventricular ejection fraction, left atrial end-systolic diameter, left ventricular end-diastolic diameter, distance from the catheter tip to superior vena cava beyond right atrial opening) had influence on the insufficient catheter flow in the early stage between the two groups were analyzed.Results:The differences of left ventricular ejection fraction, left atrial end-systolic diameter and position of catheter tip between the two groups were statistically different( P<0.05). However, univariate and multivariate analyses showed that there were significant differences in catheter tip approaches and touches the wall of right atrium( OR=5.393, 95% CI=2.039-14.263, P=0.001), increased left atrial end-systolic diameter( OR=0.321, 95% CI=0.124-0.827, P=0.019), left ventricular ejection fraction in critical range( OR=2.953, 95% CI=1.113-7.835, P=0.030) and decreased left ventricular ejection fraction( OR=5.828, 95% CI=1.869-18.174, P=0.002) were the independent risk factors of early insufficient catheter flow. Conclusions:Insufficient catheter flow after central venous catheterization is related to catheter position, left atrial end-systolic diameter and left ventricular ejection fraction. Ultrasonography evaluation is a primary method to observe the position of the catheter tip in dialysis patients and diagnose the early insufficient catheter flow after central venous catheterization.