Objective To investigate the risk factors of diabetic foot by observing the changes of the relative index. Methods 134 pa-tients were randomly divided into non-diabetic foot (NDF) group and diabetic foot (DF) group,the changes of blood glucose,HbA1c,creati-nine,uric acid,microalbuminuria and the complications of diabetes were observed. Results There no difference in blood glucose level be-tween 2 groups (P>0. 05). The HbA1c levels of DF group was higher,with a significant difference(P<0. 05). The levels of uric acid in fe-male of DF group was higher than those in female of NDF group(P<0. 05). there was significant differernces in levels of microalbuminuria (P<0. 05),but no statistic difference in levels of potassium and sodium between 2 groups. Conclusion The changes of HbA1c,uric acid and microalbuminuria could indicate the diabetic foot in clinic.

Objective To observe the impact of DPP4 inhibitor Saxagliptin on body weight of type 2 diabetes patients. Methods In this randomized and parallel study,50 patients were given either Saxagliptin(n=25)or Glimepiride(n=24). The changes of body weight, HbA1c and hypoglycemic events were observated in 12 weeks. Results There were no significant difference in gender,age and body weight between 2 groups(P>0. 05). After 12 weeks treatment,body weight has significant changed in both group,and the weight changes were sig-nificant differet in two groups:an average of 0. 4 kg weight was increased in Glimepiride group and 0. 4 kg weight was decreased in Saxagliptin group (P<0. 05). The change of HbA1c level has no statistical difference in two groups (P>0. 05). Hypoglycemia event was happened four times in Glimepiride group,while no hypoglycemia event was happened in Saxagliptin group. Conclusion Compared with Glimepiride,Saxa-gliptin provides similar hypoglycemic action with less hypoglycemia,at the same time,Saxagliptin yields better results in lowering weight.

Objective To evaluate the potential value of next-generation sequencing ( NGS) as a diagnostic method for listeria infection in central nervous system ( CNS ) . Methods To identify the potentially pathogenic microorganisms ( PPMs) of the five patients with CNS infection in the Department of Neurology, People's Hospital of Zhengzhou University from June 2017 to November 2017, blood or cerebrospinal fluid ( CSF ) was detected not only using common laboratory tests , including routine , biochemical, cytologic, culture and Gram-staining methods, etc, but also using the BGISEQ-100 sequencing platform to identify the PPMs of CSF .Concomitantly , we collected concurrent clinical data , then performed a comprehensive analysis of their clinical , laboratory , and auxiliary examination data .Results Of the five cases (male :female: 1:4, age ranges: 26 -61 years), the disease mainly occurred in summer.Three patients received immunosuppressants treatment before infection , and three patients had gastrointestinal syndrome in the prodromal period .Infection of CNS led to fever , headache and meningeal irritation sign in all the patients.The medical imaging examinations showed the invasion of meninges , brainstem, and the periventricular gray matter.The cell count of CSF was more than 500 ×106/L.NGS techniques showed listeria genome sequence ranged from 57 to 2611, and the coverage of listeria varied from 0.23％ to 14.00％, and PCR results supported the existence of listeria .Conclusion NGS is beneficial to make the diagnosis of listeria infection in CNS , and can help guide early treatment .

Objective To analyze the clinical and electrophysiological features in a family with spinal muscular atrophy (SMA), and assess the probable causative gene mutations for the family. Methods To identify the nosogenesis of the proband with weakness and atrophy in the double lower proximal limbs, clinical data of his 12 family members were collected, and the proband and his mother were selected for clinical examinations, including laboratory tests, electromyogram (EMG), F-wave, H-reflex, X-ray of the spine and double lower limbs, brain and spinal cord magnetic resonance imaging, etc. Moreover, human whole exome sequencing was performed on blood sample from the proband, then its deleterious effects were assessed according to the Standards and guidelines for the interpretation of sequence variants, a joint consensus recommendation of the American College of Medical Genomics (ACMG) and the Association for Molecular Pathology (AMP). Subsequently, the strong pathogenic mutation was validated by Sanger sequencing. Results Familial investigation showed seven of 12 family members presented with weakness in the double lower proximal limbs. Among them, three had the main manifestation of atrophy in the double lower proximal limbs, one had high arched foot as the main presentation, and the others had weakness in the double lower proximal limbs. EMG studies showed the abnormal results in the anterior horn of the spinal cord. The strong pathogenic mutation in DYNC1H1 gene (exon8, c.2327C＞T, p.P776L) was identified from the proband according to ACMG and AMP guidelines. Sanger sequencing revealed six patients had this variant and it was passed mainly from his maternal grandmother. Conclusions A pathogenic mutation of the DYNC1H1 p.P776L in six Chinese pedigrees which cosegregated with SMA was identified. There existed individual differences in clinical presentations. This finding may have important implications for the study of SMA in Chinese patients.