Objective:To compare therapeutic effects on type 2 diabetes mellitus (T2DM) between glucagon-like peptide 1 (GLP-1) receptor agonist and dipeptidyl peptidase-4 (DPP-4) inhibitor.Methods: A total of 96 T2DM patients treated in our hospital from Jan 2015 to Jan 2016 were selected.According to random number table method, patients were randomly and equally divided into GLP-1 receptor stimulant group (GLP-1 group, received GLP-1 receptor stimulant liraglutide treatment) and DPP-4 inhibitor group (DPP-4 group, received DPP-4 inhibitor sitagliptin treatment), both groups were treated for 18 weeks.Levels of fasting blood glucose (FBG) and 2h postprandial blood glucose (2hPG) were measured and compared, and incidence of adverse reactions were compared between two groups before and after treatment.Results: Compared with before treatment, after 18-week treatment, there were significant reductions in levels of FBG and 2hPG in both groups, P<0.05 or <0.01.Compared with DPP-4 group after treatment, there were significant reductions in levels of FBG [(7.48±0.45) mmol/L vs.(6.64±0.28) mmol/L] and 2hPG [(11.15±1.01) mmol/L vs.(9.26±1.82) mmol/L] in GLP-1 group, P<0.05 both.There was no significant difference in incidence rate of total adverse reactions (29.2% vs.33.3%) between GLP-1 group and DPP-4 group, P=0.078.Conclusion: Compared with DPP-4 inhibitor, GLP-1 receptor stimulant is better in controlling blood glucose and reducing body weight in T2DM patients, which is worth extending.

Objective To observe the effect of aspirin intervention on thrombosis in lung cancer patients with peripherally inserted central catheter (PICC).Methods From December 2007 to June 2012,a total of 997 cases of lung cancer received PICC insertion in Shanghai Chest Hospital.The patients admitted from December 2007 to October 2011 were in the control group (n =562),while those admitted from November 2011to June 2012 were in the intervention group (n =435).The control group received conventional catheterization and saline tube sealing; the study group was treated with the modified Seldinger technique,oral administration of aspirin enteric tablets,and diluted heparin sodium tube sealing.Results The incidence of thrombosis was4.09％ (23/562) in the control group and 2.99％ (13/435) in the intervention group.In the control group,17 cases of thrombosis occurred within 1 week after catheter insertion,3 between 1 week to 1 month,and 3 after 1 month ; in the intervention group,4 cases of thrombosis occurred within 1 week after catheter insertion,5between 1 week to 1 month,and 4 after 1 month,presenting a significant difference compared with the control group (Z =-2.221,P =0.026).A significant intergroup difference was also observed in terms of thrombus location (Z =-2.066,P =0.039):in the control group,17 cases had thrombus in peripheral superficial vein,and 6 in supraclavicular vein or internal jugular vein; while in the intervention group,5 cases had thrombus in peripheral superficial vein,and 8 in supraclavicular vein or internal jugular vein.Conclusion The prophylactic oral administration of aspirin could effectively reduce the thrombosis in lung cancer patients treated with chemotherapy via PICC.

Objective To investigate the optimal self care in lung cancer patients with peripherally inserted central catheter (PICC) in ladder-type nursing training,network education,continuing nursing care clinics,and other forms of nursing mode care.Methods Based on the baselien data of patients in the control group and observation group,PICC self management ability,PICC quantitative data,PICC-related infections,thrombosis,and other complications were compared,and the impact of continued nursing platform on lung cancer patients with indwelling PICC was analyzed.Results In the observation group self management ability and health behavior is higher than that of the control group (P＜0.001).PICC catheter -related complications no difference with the control group (P＞0.05),Patient satisfaction of the observation group than the control group,the difference was statistically significant (92.18％ vs.79.00％,P=0.015).Conclusion The self care based on the continued nursing mode established by PICC speciality nurses can improve the self-management level of patients with PICC,reduce PICC-related complications,and increase the patient's satisfaction.

Objective To investigate the characteristics and the enhanced patterns of carotid plaque using contrast-enhanced ultrasound (CEUS) and patients with cerebral infarction.Methods The patients with carotid plaque were divided into two groups according to whether they had cerebral infarction:54 patients (62 plaques with CEUS) with cerebral infarction were included in group A,and 48 patients (54 plaques with CEUS) without cerebral infarction were included in group B.The plaques were divided into four grades according to the degree of plaque enhancement.According to the source of intraplaque contrast agents,plaque enhancement patterns were divided into adventitia enhancement,lumen enhancement and mixed enhancement.To analyze the degree and pattern of carotid plaque enhancement in the two groups.Results Carotid plaque enhancement in cerebral infarction group was mainly grade 3 (26/62) and grade 4 (22/62),while that in non-cerebral infarction group was mainly grade 2 (20/54) and grade 3 (20/54).There was significant difference between the two groups in the proportion of carotid plaque enhancement of grade 2 (P =0.019) and grade 4 (P =0.041).The proportion of plaque adventitia enhancement model in group A(27/59) was lower than that in group B (37/50),with statistically significant difference (P =0.003).While the proportion of mixed enhancement mode in group A was significantly higher than that in group B (P =0.003).Conclusions The enhancement of carotid plaque was obvious in cerebral infarction patients,and the mixed enhancement pattern was more common.It suggested that the communication between vascular cavity and plaque might be an important factor leading to cerebral infarction.

Objective To study on the relationship between the serum level of highsensitivity c-reaction protein (hs-CR),matrix metalloproteinase 9 (MMT-9),tissue inhibitor of metalloproteinase 1 (TIMP-1) and carotid plaque stability in elderly people.Methods According to the carotid ultrasonography examination,120 old people were divided into vulnerable plaque group (group A,n =45),stable plaque group (group B,n =41) and no plaque group (group C,n =34),and serum levels of hs-CRP,MMP-9,TIMP-1 in each group were also detected.Results The serum levels of hs-CRP and MMP-9 of unstable plaque group and stable plaque group were higher than those of non-plaque group (P ＜ 0.05).hsCRP and MMP-9 were positively correlated with carotid plaque unstability,while TIMP-1 was negatively correlated with carotid plaque unstability,hs-CRP,MMP-9 and TIMP-1 were independent risk factors for carotid plaque stability.Conclusions Serum levels of hs-CRP,MMP-9 and TIMP-1 are closely related to the stability of carotid plaque.Elevated levels of hs-CRP and MMP-9 increase the risk of carotid plaque,and elevated levels of TIMP-1 decrease the risk of carotid plaque.