[Summary] The general status of glycemic control and insulin initiation are not optimistic in Chinese patients with type 2 diabetes.Chinese patients experience pancreatic β-cell dysfunction and reduction of early phase insulin spike earlier and more severely compared to Caucasians.These can cause more significant postprandial hyperglycaemia which is further deteriorated by traditional carbohydrate-rich Chinese diet.Therefore,premixed insulin may be a more appropriate option of insulin initiation therapy for Chinese patients with type 2 diabetes mellitus.

The development of liver surgery can be divided into several stages, including wedge liver resection, regular segmental liver resection and anatomical liver resection. With the development of biomedical sciences and information technology, liver surgery has developed into precise hepatectomy. The goals of precise hepatectomy are minimal invasion, maximal liver protection and best rehabilitation, This is mainly achieved through accurate preoperative evaluation, precise surgical planning, sophisticated surgical procedure and postoperative management. Its application significantly improves prognosis and quality of life of patients. This paper summarizes the concept and surgical technique of precise liver resection.

Objective To compare the point-of-care testing (POCT) and laboratory testing of myocardial damage markers in the diagnosis and prognosis of acute coronary syndrome (ACS).Methods A total of 3467 patients with ACS who were treated in the Emergency Department Beijing Chaoyang Hospital Affiliated to Capital Medical University between January 1,2006 and June 30,2010 were retrospectively reviewed.The patient demographics (age,sex,past medical history and smoking history) and laboratory testing results (myocardial damage markers,D-dimer,NTproBNP,and ejection fraction [EF]) were analyzed.The patients who received POCT or laboratory testing of myocardial damage markers were compared with regard to emergency department stay (i.e.,the time from the emergency visit to interventional or conservative treatment),cardiovascular events during hospitalization (congestive heart failure,ventricular fibrillation,and cerebrovascular disease),and 28-day mortality rate.Results The emergency department stay,incidence of a cardiovascular event,and 28-day mortality in the POCT group were all lower than that in the laboratory testing group (P =0.000).A prolonged emergency department stay result in an increased incidence of 28-day mortality.The higher level of D-dimer and decreased EF prompted an increased incidence of 28-day mortality.Conclusions Compared with conventional laboratory testing,POCT can significantly shorten the length of an emergency department stay for an ACS patient,decrease the incidence of a cardiovascular event,and improve the prognosis.

Objective:To explore the clinical significance of the combined detection of Clara cell secretory protein 16 (CC16) and soluble receptor for advanced glycation end product (sRAGE) in the diagnosis and prognosis of acute respiratory distress syndrome (ARDS).Methods:100 ARDS patients admitted to the intensive care unit (ICU) of Chu Hsien-I Memorial Hospital of Tianjin Medical University from July 2019 to September 2020 were enrolled as the ARDS group, and 100 non-ARDS patients admitted to the ICU during the same period were enrolled as the control group. The general information, vital signs, blood gas analysis, serum CC16 and sRAGE levels, duration of mechanical ventilation, length of ICU stay and prognosis during hospitalization were collected. The receiver operating characteristic (ROC) curve was drawn and the area under ROC curve (AUC) was calculated to evaluate the clinical value of CC16 and sRAGE lonely or combination in the diagnosis and prognosis of ARDS.Results:The duration of mechanical ventilation in the ARDS group was significantly longer than that in the non-ARDS group (days: 15.44±3.04 vs. 12.61±3.73, P < 0.01), and the hospitalization mortality was higher (38.0% vs. 9.0%, P < 0.01), but there was no significant difference in gender, age, body mass index (BMI), acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score or the length of ICU stay between the two groups. There were 62 ARDS patients survived and 38 ARDS patients died during hospitalization. The APACHEⅡ score of the death group was significantly higher than that of the survival group (23.55±2.83 vs. 19.40±4.10, P < 0.01), but there was no significant difference in age, BMI, oxygenation index, mean arterial pressure, duration of mechanical ventilation or the length of ICU stay between the two groups. The serum levels of CC16 and sRAGE in the ARDS group were significantly higher than those in the non-ARDS group [CC16 (mg/L): 38.78±14.70 vs. 21.87±2.45, sRAGE (pg/L): 2 470.95±288.70 vs. 2 013.22±131.15, both P < 0.01]; and the serum levels of CC16 and sRAGE of ARDS patients in the death group were significantly higher than those in the survival group [CC16 (mg/L): 42.02±10.81 vs. 30.52±9.47, sRAGE (pg/L): 2 638.34±324.07 vs. 2 279.91±163.70, both P < 0.01]. ROC curve showed that the AUC of CC16 and sRAGE in the diagnosis of ARDS alone were 0.859 [95% confidence interval (95% CI) was 0.808-0.911] and 0.821 (95% CI was 0.762-0.879), and the best cut-off values were 25.76 mg/L and 2 203.00 pg/L, respectively; the AUC of combined detection of CC16 and sRAGE was 0.932 (95% CI was 0.900-0.965) with the sensitivity of 89.0% and the specificity of 87.6%. The AUC of CC16 and sRAGE in predicting the death of patients with ARDS during hospitalization were 0.747 (95% CI was 0.651-0.843) and 0.819 (95% CI was 0.737-0.902), and the best cut-off values were 32.95 mg/L and 2 554.50 pg/L, respectively; the AUC of combined detection of CC16 and sRAGE was 0.900 (95% CI was 0.828-0.972) with the sensitivity of 88.7% and the specificity of 84.5%. Conclusions:Serum CC16 and sRAGE have clinical value for the diagnosis and prognosis of ARDS. The combined detection of them is superior to individual detection for early prediction of ARDS and prognosis.

Objective: To analyze the Effect of isokinetic training on knee injury patients’ recovery function. Methods: Choose knee injury patients between October 2012 to October 2013 as research object, randomly divided into control group received conventional training, and observe group received isokinetic training, each with 49 cases, detecting knee function after training, stretching flexor muscle strength, range of motion. Results: 1) After training ,both groups of patients inflammation Lysholm knee function scores were higher than before,and observation group patients Lysholm knee function score were significantly higher; 2)After training, both groups extensor flexor muscle strength were higher than before,and the observation group patients’ stretched flexor PT, AP, MRTW level were higher; 3)After eight weeks of training and 16 weeks, observation group patients’ knee extension, knee flexion angles were significantly higher.Conclusion:Isokinetic exercise training can improve knee joint function in patients, improve muscle strength while expanding its range of motion, improve the quality of life of patients.

BACKGROUND:Studies have found that bone marrow mesenchymal stem cel s, under certain conditions, can be induced to differentiate into neurons and glial cel s, which to some extent solves the problem of the source of seed cel s. Induction methods currently used are different, and their efficiencies are not the same.
OBJECTIVE:To observe the effects of different antioxidants on differentiation of rat bone marrow mesenchymal stem cel s into neuron-like cel s in vitro.
METHODS:Bone marrow mesenchymal stem cel s from Wistar rats were divided into four groups:non-intervention group,β-mercaptoethanol group, retinoic acid group,β-mercaptoethanol+retinoic acid group. Changes in cel morphology and positive rate of neuron-specific enolase and microtubule-associated protein 2 were observed and detected at 5 hours, 12 hours, 1 day, 3 days, 5 days, 7 days, and 10 days after induction.
RESULTS AND CONCLUSION:Except non-intervention group, bone marrow mesenchymal stem cel s in the other three groups were gradual y becoming spindle-shaped, and gave birth to many smal protrusions that were interconnected into a network, showing neuron-like cel morphology. Immunocytochemical staining showed that the efficiency of theβ-mercaptoethanol+retinoic acid group was the highest at 10 days after induction, and the positive rates of neuron-specific enolase and microtubule-associated protein 2 were 71.63%and 79.72%, respectively. The results show thatβ-mercaptoethanol can be combined with retinoic acid to accelerate the differentiation of bone marrow mesenchymal stem cel s into neuron-like cel s.

Enzyme histochemistry of neurons in the enteric nerve plexus of guinea pigs were studied with light microscope semi-quantitatively and microphotometer quantitatively. The results showed that the neurons differ greatly in A1P (alkaline phosphatase), AcP (acid phosphatase), 5'-Nase (5'-Nucleotidase), TPPase (thiamine pyrophosphatase), NsE (non specific esterase) and ChAT (choline acetyltransferase). There were disparities to a certain extent in reactions of MAO (monoamine oxidase), AP (aminopeptidase) and AChE (acetylcholinesterase) among different segments of gastrointestinal between submucous and myenteric plexus, but all neurons were positive for the enzymes stated above. The neurons in each ganglion were relatively similar in the enzyme activities. There were about 50-66% neurons in the enteric nerve plexus showing strong reaction of ChAT, which may be cholinergic neurons. There were significant differences in enzymatic activities, except NsE, between submucous plexus and myenteric plexus statistically. Submucous plexus showed stronger reactions of AcP and AP than those of myenteric plexus, while myenteric plexus showed stronger reactions of A1P, 5'-Nase, TPPase, MAO, ChAT than those of submucous plexus. The ganglia of intramural plexus in stomach were not well developed as those of intestine, especially the submucous plexus of stomach, in which there were only few scattered neurons, and they showed weaker enzyme activities than those of intestine. The enteric neurons in duodenum and proximal colon showed strongest activities for most enzymes among different segments of intestine. The above results indicate that the enteric neurons exist remarkable differences in metabolism and functional states.

Blood Cells ; immunology ; pathology ; Bone Marrow Cells ; immunology ; pathology ; Child, Preschool ; Diagnosis, Differential ; Female ; Humans ; Immunophenotyping ; Leukemoid Reaction ; diagnosis

Epstein-Barr Virus Infections ; Humans ; Lymphoproliferative Disorders ; diagnosis ; genetics

The article analyses the actualities and causes of present-day college students'vocational values.Then it elaborates how to guide college students to have correct vocational values.Teaching college students' vocational values is a comprehensive work over a long period of time.