Objective To compare the effect of insulin pump continuous subcutaneous insulin (CSII) and multiple subcutaneous insulin (short-acting insulin before meals + glargine,MSII) for the short duration of type 2 diabetes mellitus (T2DM) patients.Methods Fifty-two newly diagnosed T2DM patients were randomly divided into CSII(n =29) and MSII(n =23) group.Patients in CSII group were given insulin pump continuous subcutaneous plus metformin.And patients in MSII group were given insulin by multiple subcutaneous insulin injection plus metformin.The treating periods was 2 weeks and followed up one month.Results The periods from point of insulin injection to blood glucose back to normal level in CSII group was (4.70 ±2.01) d,shorter than that in MSII group(6.90 ± 1.50) d,and the difference was significant(t =2.056,P ＜0.05).The levels of C peptide in two hours postprandial before and after treatment in CSII group were (4.24 ± 0.25) ng/L,(6.29 ± 0.56) ng/L,and (3.20 ±0.11) ng/L and (7.33 ±0.41) ng/L respectively in MSII group.The levels of C peptide in two hours postprandial after treatment were higher than that of before treatment in two groups (t =2.018,2.436 respectively,P ＜0.05),but there were no significant differences between two groups(t =0.985,P ＞ 0.05).Nineteen cases (65.5％) in CSII group were off insulin treatment in one month,and 9 cases (39.1％) in MSII group.There were significant differences in two groups(x2 =5.11,P ＜0.05).Conclusion The two treatment plans can make the improvement in terms of glucose control.However,CSII plan showed more effective than MSII.

Objective To summarize the CT and MRI features of radiation-induced sarcoma (RIS) after radiotherapy in patients with nasopharyngeal carcinoma (NPC).Methods From January 1997 to October 2012,a total of 73 NPC patients with RIS after radiotherapy were confirmed by pathology.The clinical data and imaging findings (CT and MRI findings) were retrospectively reviewed.Of the 73 patients,43 underwent CT examination,24 underwent MRI,and the remaining 6 underwent both CT and MRI scans.Results Fibrosarcoma [45.3％ (33/73)] was the most frequently histologic type,followed by osteosarcoma[31.5％ (23/73)] and malignant fibrous histiocytoma [9.6％ (7/73)].The top three common sites were maxillary sinus [26.7％ (20/73)],followed by the neck soft tissue [17.8％ (13/73)] and mandible[13.7％ (10/73)].The main characteristics of the RIS on CT and MRI were soft tissue masses[78.1％ (57/73)] with an irregular shape and ill-defined margin,or rounded masses with welldefined margin [21.9％ (16/73)].CT of 49 patients showed masses with isodensity or mixed density on precontrast CT.MRI of 30 patients showed lesions with isointensity signal on T1WI and intermediate signal intensity on T2WI.On post-contrast images,65.8％ (48/73) tumors showed markedly homogeneous or inhomogeneous enhancement,23.2％ (17/73) lesions showed moderate enhancement,and 11.0％ (8/73) masses showed mild enhancement.Among the 23 patients with radiation-induced osteosarcomas,78.3％ (18/23) presented tumor bone formation.Conclusions RIS has a characteristic imaging features.Clinical history,tumor sites and serial imaging follow-up are necessary for early detection of RIS in patients with NPC.

Objective:To explore the clinical utility of tongue pressure resistance feedback training in the treatment of post-stroke dysphagia.Methods:Twenty stroke survivors with dysphagia were randomly divided into an experimental group and a control group. Both groups were given conventional swallowing rehabilitation training, while the experimental group was additionally provided with tongue pressure resistance feedback training. Before and after the treatment, MBSImp analysis and the Rosenbek penetration aspiration scale were used to quantify the control of the tongue, food delivery, oral residue, laryngeal elevation, hyoid bone movement, epiglottis turnover, larynx closure, vestibular larynx closure, pharyngal peristalsis and contraction, opening of the upper esophageal sphincter UES, contraction of the base of the tongue, pharyngeal residue and aspiration.Results:No significant differences were observed between the two groups before the intervention. Afterward the average pharyngeal period and aspiration score of the experimental group had decreased significantly compared with the control group′s values.Conclusions:Tongue pressure resistance feedback training is effective in improving pharyngeal swallowing and reducing the risk of aspiration after swallowing.

Objective Summarize the characteristics of infectious disease reporting management, reflect on the exposed problems, and make reference suggestions under the situation of COVID-19. Methods In-depth analysis through literature research and practical demonstration. Results The functions of each department, organic integration, unified management, communication from top to bottom, upgrade and perfection, and information sharing can give full play to the early warning role of infectious disease surveillance. Conclusion The infectious disease reporting management system should be perfected and upgraded from top to bottom and from the inside out.

OBJECTIVE：To establish HP LC ch aracteristic ch romatogram of different medicinal parts of Cirsium japonicum ， and to compare the difference of chemical components in different medicinal parts of C. japonicum according to chemical identification method ，and to provide reference for quality control and evaluation of C. japonicum . METHODS ：Medicinal material （overground part ），leaves，flower，main stem and lateral stem of C. japonicum were determined by HPLC. According to the TCM Chromatographic Fingerprint Similarity Evaluation System （2012A edition ），the chromatograms were matched to generate the HPLC characteristic chromatogram of each medicinal part. The differences of common characteristic peak area were analyzed according to variance analysis of single factor. The chromatographic peaks were identified by comparison of reference substance. Meanwhile，the chemical pattern recognition was performed to research the different medicinal parts of C. japonicum according to principal component analysis （PCA）and cluster analysis. RESULTS ：HPLC characteristic chromatograms of medicinal material ， leaves，flower，main stem and lateral stem from C. japonicum were established respectively ，and 15 common peaks were confirmed for medicinal material ，leaves and flower of C. japonicum ；11 common peaks were confirmed in chromatograms of main stem and lateral stem from C. japonicum （absence of No. 7，9，12，13 peak）. The contents of chemical components were different greatly among different medicinal parts. No. 1，2，3，10，11 peaks were identified as neochlorogenic acid ，chlorogenic acid ， cryptochlorogenic acid ，linarin and pectolinarin. Results of PCA and cluster analysis showed that chemical pattern recognition and clustering of the flower and stem of C. japonicum were distinct and can be clustered into one category respectively. However ，the leaves distribution of C. japonicum was relatively scattered ，so it was difficult to cluster . CONCLUSIONS ：Established HPLC characteristic chromatogram-chemical pattern recognition can reflect the differences of different medicinal parts of C. japonicum integrally， comprehensively and truly ， which has vital significance for origin indentification ， quality control and overall evaluation of C. japonicum .

OBJECTIVE：To provide reference for the identification and proces sing end-point determination of raw Morus alba and its processed products （honey-processed M. alba ）. METHODS ：UPLC method was adopted. The determination was performed on Waters BEH Shield RP C 18 column with mobile phase consisted of acetonitrile- 0.1％ phosphoric acid solution （gradient elution ） at the flow rate of 0.30 mL/min. The column temperature was set at 30 ℃. The program wavelengths were set at 280 nm（0-4 min） and 320 nm（4-35 min）. Similarity Evaluation System for Chromatogram Fingerprint of TCM （2012 edition）was used to establish UPLC fingerprint and carry out similarity evaluation of 13 batches of M. alba and honey-processed M. alba . The chromatographic peaks were identified with reference substance fingerprint. The colorimetric value （L，a，b） of 13 batches of M. alba and honey-processed M. alba powder were determined ，and average total colorimetric value （E）was calculated. OPLS-DA and cluster analysis were adopted to analyze the differences in fingerprints and colorimetric values of M. alba before and after processing. At the same time ，the dynamic change rule of fingerprint and colorimetric value of honey-processed M. alba at different processing time points were analyzed to determine the processing end-point. RESULTS ：There were obvious differences in fingerprints before and after processing ，and the similarity of 13 batches of M. alba and honey-processed M. alba were all higher than 0.9. Totally 21 common peaks were calibrated for M. alba ，and 23 common peaks for honey-processed M. alba ；peak 1 and peak 2 were newly produced compounds of honey-processed M. alba . Peak 2，peak 7，peak 14 and peak 19 were identified as 5-hydroxymethylfurfural， mulberry glucoside A ，oxidized resveratrol ，mulberry flavonoids G. Results of OPLS-DA showed that the peak area-sample quantity ratio of peak 1，peak 2，peak 18，peak 20 and the chromaticity values （L，a，b）were the most important factors affecting the difference of raw and processed products of M. alba . When the E ranged 75.84-80.88 as the processing end-point of honey-processed M. alba ，the processing time was determined as 22-34 min. CONCLUSIONS ： The established UPLC fingerprint and colorimetric value determination method can be used to identify the raw and processed products of M. alba as well as determine the processing end-point of honey-processed M. alba .