Objective To explore modification of islet cell function in type 2 diabetes by the treatment of insulin detemir and insulin aspart.Methods A total of 68 patients with diagnosed type 2 diabetes were randomized into two grouops,the control group (insulin glargine combined with insulin aspart)and observation group (insulin detemir combined with insulin aspart),each group had 34 cases.Before and after treatment,fasting insulin and 2 h postprandial insulin,glycated hemoglobin (HbA1c),C peptide and fructosamine (FMN)levels were compared in two groups,and the treatment safety was observed.Results After treatment,fasting insulin and C -peptide levels in the two groups were significantly increased than before treatment(P <0.05 ).In observation group,2 h postprandial insulin level (29.97 ±9.18)mIU /L was significantly higher than before treatment (20.79 ±7.49)mIU /L(t =4.52,P =0.00), which was better than the control group (24.67 ±7.69)mIU /L,the difference was significant (t =2.58,P =0.01). After treatment,postprandial 2h C peptide levels in the two groups had no significant differences compared with before treatment (P >0.05).In the observation group,except for 2h postprandial insulin levels,other indicators had no significant differences compared with the control group (P >0.05 ).After treatment,FMN and HbA1c in the two groups decreased significantly compared with before treatment(P <0.05 ),but there was no significant difference between the two groups (P >0.05).During treatment,both two groups observed hypoglycemia,but there were no severe adverse reactions.Conclusion The clinical application of insulin detemir combined with insulin aspart in the treatment of type 2 diabetes can significantly improve the insulin -producing cells and accelerate functional recovery, and the clinical effect is better than the united aspart insulin glargine,with no significant adverse reactions,it can be recommended as a clinical type 2 diabetes treatment drug of choice.

ObjectiveTo explore the relationship between male adolescents' childhood abuse and externalizing behaviors,and the moderating effect of monoamine oxidase A (MAOA) gene promoter region variable number tandem repeat (VNTR) polymorphism.MethodsThrough random cluster sampling,352 Han male middle school students from Changsha were tested by Achenbach child behavior checklist-youth self reports (CBCL-YSR)and childhood trauma questionnaire-28 item short form (CTQ-SF),their MAOA genotypes were also identified.A hierarchical multiple regression analysis was used to test the moderating effect.Results ( 1 ) Compared participates with high activity MAOA gene and that with low activity MAOA gene,there were no significant differences on age ( ( 15.82 ± 1.52) vs ( 15.94 ± 1.62 ) ),externalizing behaviors ( ( 15.13 ± 10.14 ) vs ( 14.33 ± 9.70 ) ),total abuse ( (52.59 ± 10.46) vs (51.39 ± 7.56 ) ),emotional abuse( ( 7.63 ± 3.31 ) vs ( 7.11 ± 2.68 ) ),physical abuse ( ( 6.40 ± 2.82) vs (6.12 ± 2.05 ) ),sexual abuse ( ( 6.42 ± 3.24 ) vs ( 5.94 ± 1.72 ) ),emotional neglect ((13.44±5.12) vs (13.16 ±4.83) ),physical neglect( (10.27 ±2.64) vs (10.44±2.53))(t=-1.789～0.678,P ＞ 0.05 ).(2)Except emotional neglect and physical neglect,emotional abuse,physical abuse and sexual abuse could predict externalizing behaviors( Sβ =0.141 ～0.347,P ＜ 0.01 ).(3) MAOA gene was not directly related to externalizing behaviors( Sβ =- 0.023,P ＞ 0.05 ).There was a significant interaction between MAOA gene and emotional abuse( Sβ =-0.148,P ＜ 0.01 ).The interaction between MAOA gene and physical abuse or sexual abuse showed no statistical significance( Sβ =- 0.067,- 0.005,P ＞ 0.05 ).ConclusionMAOA gene polymorphism can moderate the relationship between male adolescents'childhood emotional abuse and externalizing behaviors.

Objective To examine the impact on impulsivity trait by monoamine oxidase A variable nucleotide tan?dem repeat (MAOA-VNTR) genotype and children’s abuse experience. Methods The self-reported questionnaire of Bar?ratt Impulsiveness Scale (BIS), Childhood Trauma Questionnaire (CTQ) were conducted in 403 normal Han female adoles?cents from north-west of China. The DNA were extracted from their venous blood sample and were genotyped for the MAOA-VNTR polymorphism. A linear regression model was used to investigate the main effects of MAOA-VNTR and children's abuse, and their interaction effect on impulsivity. Results The main effect of Children’s maltreatment experi?ence on trait impulsivity was significant (P<0.01). The main effect of MAOA-VNTR gene and the interaction between MAOA-VNTR genotype and children's maltreatment experience were insignificant (P>0.05). Conclusion The MAOA-VNTR genotype may not be involved in the female adolescents’impulsivity traits related to childhood maltreat?ment.

Objective To explore the interaction between a serotonin transporter gene promoter region polymorphism(5-HTTPR) and stress in predicting anxiety symptoms.Methods Through random cluster sampling,a total of 252 healthy adolescents participated in this study.During the initial assessment,all participants completed the Adolescent Life Events Questionnaire (ALEQ) and Multidimensional Anxiety Scale for Children (MASC) to assess their levels of stress and anxiety and were genotyped for the 5-HTTLPR polymorphism.Participants subsequently completed MASC and ALEQ once every three months during the subsequent 24 months.A multilevel model was used to investigate the interaction between 5-HTTLPR and stress that predict anxiety symptoms.Results The results indicated no major effect of 5-HTTLPR in males (β=0.80,P＞0.05)or females(β=-0.21,P＞0.05).There were major effects of stress in males(β=0.30,P＜0.01) and females (β=0.33,P＜0.01)and a significant interaction between 5-HTTLPR and stress.Females with at least one 5-HTTLPR S allele(β=0.11,P＜ 0.01)and males with at least one 5-HTTLPR L allele(β=-0.10,P＜0.01)exhibited more anxiety symptoms under stressful situations.Conclusion The interaction between 5-HTTLPR and stress can predict anxiety symptoms in adolescents.There are gender differences on the 5-HTTLPR × stress interaction.

Objective:To investigate gender measurement invariance of the Perceived Social Support Scale(PSSS)in people aged 50 years and older.Methods:A total of 1013 adults(50-96 years old)in Beijing, Hunan and Shandong were tested by using PSSS.The measurement invariance of PSSS between middle-aged and elderly males and females was analyzed.Differences in PSSS total scores and subscale scores between males and females were examined.Results:The equivalence test results of each item in the questionnaire met the requirements of the metrology(△CFI≥0.010, △TLI≥0.010, △RSMEA≤0.015), indicating that the hypotheses of morphological equivalence, weak equivalence, strong equivalence and strict equivalence of PSSS were all valid in the middle-aged and elderly population regardless of gender.In addition, middle-aged and elderly females had higher scores in family support, support from friends, support from other people and perceived social support than their male counterparts( P<0.05). Conclusions:PSSS has cross-gender equivalence in middle-aged and elderly people.Thus, differences in PSSS can reflect the perceived social support level in middle-aged and elderly people of different genders.

Objective To investigate the epidemiological and clinical features of brucellosis in Foshan.Methods The epidemiological history,clinical manifestations,laboratory tests,treatment and outcomes of 41 patients with brucellosis from 2013 to 2016 in the First People's Hospital of Foshan were retrospectively analyzed.Results Brucellosis onsets occurred mainly from February to June [85.4％ (35/41)],and 58.5％ (24/41) of them had positive epidemic history.Irregular fever,rachialgia/arthralgia,fatigue and hepatosplenomegaly occurred in 29 (70.7％),20 (48.8％),19 (46.3％) and 16 (39.0％) of the patients,respectively.The C-reactive protein (hs-CRP) of patients infected with Brucella only was lower than that in patients infected also with other bacteria (26.72 vs 50.87 mg/L,Z =-2.300,P ＜ 0.05),but no significant difference of white blood cell counts (5.77 × 109/L vs 5.83 × 109/L),neutrophil (3.50 × 109/L vs 3.84 × 109/L) and procalcitonin (PCT,0.10 vs 0.14 μg/L) between the two groups were observed.The patients with positive epidemic history had lower white blood cell,neutrophil and monocyte counts than those who did not had epidemic history (4.73 × 109/Lvs 7.28 × 109/L,2.73 × 109/L vs 4.79 × 109/L,and 0.36 × 109/L vs 0.64 × 109/L;F =9.486,10.130,9.785,P ＜ 0.05).And no significant difference of lymphocyte counts,hs-CRP and PCT between the two groups were observed (1.57 × 109/L vs 1.73 × 109/L,29.30 vs 35.76 mg/L,and 0.15 vs 0.09 μg/L;P ＞ 0.05).All the cases were infected by Brucella melitensis,and 33 of them were sensitive to general antibiotics in vitro.There were 40 cases discharged after treatment,and 34 cases still needed to increase antibiotic treatment courses.Most patients had good outcomes.Conclusions In Foshan,patients with irregular fever and rachialgia or arthralgia,and no significantly increased inflammation index,should be aware of brucellosis.We should strengthen the screening of brucellosis in Foshan.

Objective:To analyze the risk factors for postoperative delirium in patients with glioma, and construct and validate a nomogram prediction model.Methods:A total of 304 glioma surgery patients admitted to the Department of Neurosurgery of Shandong Provincial Hospital from January 2021 to January 2022 were involved in this research. The training set (234 patients) and the validation set (70 patients) were divided according to the leave-out method. Patients in the training set and validation set were divided into delirium and non-delirium groups using the confusion assessment method (CAM) as the criteria.Clinical data of patients in the two study groups in the training set were analyzed.The risk factors for postoperative delirium were clarified by Logistic regression analysis, and an early warning model for postoperative delirium in glioma was established. The calibration curve and ROC curve were used for internal and external validation in the training set and validation set to evaluate the accuracy and discrimination of the prediction model.Results:Multivariate Logistic regression analysis showed that age>60 ( OR=4.089, 95% CI=1.898-9.103, P<0.001), diabetes ( OR=2.825, 95% CI=1.316-6.186, P=0.008), hypertension ( OR=2.176, 95% CI=1.041-4.587, P=0.008), smoking ( OR=2.432, 95% CI=1.063-5.648, P=0.036), history of epileptic seizures ( OR=4.457, 95% CI=1.924-10.689, P=0.001), poor lung function ( OR=2.452, 95% CI=1.132-5.374, P=0.023), visual analog scale (VAS)>7 points ( OR=3.394, 95% CI=1.591-7.456, P=0.002), anxiety or depression ( OR=2.746, 95% CI=1.285-5.976, P=0.010) and operation duration>4 h ( OR=2.731, 95% CI=1.255-6.062, P=0.012) were the independent risk factors of brain glial postoperative delirium.Based on the above risk factors a nomogram nursing early warning model was established.The area under the ROC curve (AUC) of internal verification was 0.852, and AUC of external verification was 0.914. Conclusion:The early-warning model for postoperative delirium in glioma patients can effectively predict the risk of delirium after glioma surgery, and it has certain clinical promotion value.

Objective:To investigate the effect of intranasal oxytocin administration on empathy in male adolescents with conduct disorder.Methods:The male adolescents with conduct disorder in the Psychological Counseling Clinic of the Second Xiangya Hospital of Central South University from September 2015 to August 2016 were selected.And they were randomly assigned to oxytocin group ( n=46) and placebo group ( n=51) by random number table. Subjects in oxytocin group were given nasal spray of 24 IU oxytocin twice per day for two weeks, while those in placebo group were given nasal spray of 0.9% sodium chloride solution for two weeks. The empathy of patients was assessed with a pain-related empathy task and interpersonal reactivity index (IRI) before and after two weeks′ administration. SPSS 20.0 software was used for statistical analysis, and repeated measurement analysis of variance was used to compare the empathy ability of the two groups before and after intervention. Results:Repeated measurement analysis of variance showed that there were significant time×group interaction effects in the scores of painful expressions during the pain-related empathy task ( F=13.86, P<0.001), IRI ( F=5.59, P=0.020) and empathic concern subscale ( F=4.99, P=0.028). There was significant between-group effect in the score of perspective-taking subscale of IRI( F=4.22, P=0.043). Simple effect analysis revealed that after two weeks of intervention, the score of needle-pain expression in oxytocin group was significantly higher than that at baseline ( t=-2.08, P=0.040). And the score of needle-pain expression in oxytocin group was significantly higher than that in placebo group ( t=2.33, P=0.022). After two weeks of intervention, the total IRI score ( t=-2.58, P=0.011) and empathy factor score ( t=-3.15, P=0.002) of oxytocin group were both higher than those at baseline. After intervention, the total IRI score ( t=2.30, P=0.024) and perspective-taking factor score ( t=2.57, P=0.012) in oxytocin group were higher than those in placebo group, and the differences were statistically significant. Conclusions:Oxytocin may improve the cognitive and emotional empathy in male adolescents with conduct disorder.

Objective To explore the radiation shielding optimization plan for a medical proton cyclotron developing and commissioning building at various commissioning stages. Methods According to the maximum source termsat different commissioning stages, we used the empirical formula to estimate the instantaneous dose rate at the point of interest outside the shield of the building, and optimized the building’s shielding ateach commissioning stage. Results When adding 1.0 m mobile concrete shielding blocks (“blocks” below) each to wall 3 and wall 4 at the cyclotron commissioning stage, 1.0 m blocks to wall 4 and 1.25 m blocks to wall 5 at the beam transport line commissioning stage, and 1.0 m blocks to wall 9 and 0.4 m blocks to the ceiling at the simulated treatment room commissioning stage, the dose rates at the points of interest outside the shield could meet the dose rate limit requirements. Conclusion The application of mobile concrete shielding blocks not only meets the shielding requirements, but also has economical and space-saving advantages, conforming to the principle of shielding optimization. This can be an approach to the optimization of radiation shielding for high-energy particle accelerators or similar scientific projects.

Objective:To explore the effects of mouth opening breathing for different reasons on children's maxillofacial development. Methods:One hundred and fifty-one children were selected as the research objects of this experiment. They were divided into 49 cases of adenoid hypertrophy group（group A）, 52 cases of tonsillar hypertrophy group（group B） and 50 cases of adenoid with tonsillar hypertrophy group（Group C）. Healthy children in the same period were selected as the control group, a total of 45 cases. The reflex nasopharyngeal measurement parameters, facial development indexes and cephalometric parameters of group A, group B, group C and control group were analyzed, and the incidence of Angle ClassⅡand Angle Class Ⅲ in group A, group B and group C were studied. Results:Compared with the control group, the reflex nasopharyngeal measurement parameters in group A, group B and group C was significantly different（P<0.05）, and the cephalometric parameters changed with variation in groups（P<0.05）. The incidence of Angle Class Ⅱ facial pattern in group A and group C was higher, but the incidence of Angle Class Ⅲ facial pattern in group B and group C was higher（P<0.05）. Conclusion:Adenoid hypertrophy leads to mandibular retraction; tonsil hypertrophy leads to anterior mandibular arch; adenoid hypertrophy and tonsil hypertrophy are easy to lead to clockwise rotation of the mandible. In clinical practice, to avoid children's uncoordinated maxillofacial development, we should correct the maxillofacial situation of children as soon as possible.
Child ; Humans ; Maxillofacial Development ; Malocclusion, Angle Class III/complications* ; Nasopharynx ; Adenoids ; Palatine Tonsil ; Mouth Breathing/etiology* ; Hypertrophy/complications* ; Mouth