One hundred and twenty four patients with type 2 diabetes mellitus (T2DM) admitted to the Department of Endocrinology of Chuzhou First People's Hospital from April to October 2019 whose blood glucose levels were not controlled after treatment with metformin (2.0 g/d) for more than 3 months were enrolled in the study. The patients were randomly divided into oral drug group and liraglutide group with 62 cases in each group. On the basis of metformin, the oral drug group was treated with acarbose (300 mg/d); the liraglutide group was treated with liraglutide (1.2 mg/d). The course of treatment was 3 months. The body weight, fasting blood glucose (FPG), 2-h postprandial blood glucose (2 hPG), glycosylated hemoglobin (HbA1c), cholesterol (TC) and triglyceride (TG) levels were compared between the two groups before and after treatment, and the gastrointestinal symptoms and the incidence of hypoglycemia were analyzed. After 3-month treatment the body weight, FPG, 2 hPG, HbA1c of the two groups were lower than the baseline levels ( P<0.05). Compared with the oral group, the body weight, FPG, 2 hPG, HbA1c and TG in liraglutide group were more markedly decreased ( P<0.05). The gastrointestinal reaction of liraglutide group was significantly higher than that of the oral drug group, and there was no hypoglycemia in both groups. The data indicate that liraglutide combined with metformin can significantly improve the blood glucose, blood lipid and body weight of T2DM patients and no hypoglycemia occurs during the treatment.

Objective To evaluate the predictive value of neutrophil to lymphocyte ratio(NLR) and B-type natriuretic peptide (BNP) in elderly patients with heart failure complicated with pulmonary infection. Methods 178 heart failure patients in our hospital from June 2018 to May 2020 were selected as the research objects, and they were divided into pulmonary infection group (n=92) and non-pulmonary infection group (n=86) according to whether they were complicated with pulmonary infection. The differences of NLR and BNP levels and other clinical indicators between the two groups were compared. Univariate and multivariate Cox regression were used to analyze the influence of NLR and BNP levels on heart failure complicated with pulmonary infection. The predictive value of NLR combined with BNP on heart failure complicated with pulmonary infection was analyzed by receiver operating characteristic (ROC) curve. Results Multivariate logistic regression analysis showed that NLR (OR=7.606, 95% CI: 3.123-18.526) and BNP (OR=4.264, 95% CI: 1.682-10.811) were independent risk factors of elderly heart failure complicated with pulmonary infection after adjusting for other related variables. Pearson correlation analysis showed that BNP level was positively correlated with NLR level (r=0.400, P<0.001). The area under ROC curve of NLR, BNP and NLR+BNP in predicting pulmonary infection in elderly patients with heart failure was 0.810, 0.756 and 0.838, respectively. Conclusion BNP and NLR are independent risk factors of elderly patients of heart failure with pulmonary infection .The combined detection of BNP and NLR has predictive value for those patients.

OBJECTIVE: To study the effects of long term use of beclomethasone dipropionate (BDP) nasal spray on bone density with perennial allergic rhinitis (AR) in adults. METHOD: A 5-year randomized study was conducted on the effects of BDP nasal spray on serum calcium, phosphorus, alkaline phosphatase, and bone density determined before and after the treatment in 36 adult patients with perennial AR. 20-45 years of age, were randomly divided into 3 groups. That is group A (nasal spray 1 - <3 year), group B (nasal spray BDP 3 - <5 year) and group C (nasal spray BDP > or =5 year). The data were analyzed by paired t test. RESULT: The perennial AR were followed up for more than > or =1 year, > or =3 year and > or =5 year to observe the influences of nasal spray BDP. There were no significant difference between the data examined before and after the treatment (P > 0.05). Bone development is not influenced by nasal spray BDP < or =400 microg/d within 5 years. CONCLUSION Long term use of BDP nasal spray in adult patients does not lead to osteoporosis if the lowest effective steroid dose is given.
Adult ; Alkaline Phosphatase ; blood ; Beclomethasone ; administration & dosage ; adverse effects ; therapeutic use ; Bone Density ; drug effects ; Calcium ; blood ; Female ; Humans ; Male ; Middle Aged ; Phosphorus ; blood ; Rhinitis, Allergic, Perennial ; drug therapy ; metabolism ; physiopathology ; Young Adult

Objective To explore the application of the awake anesthesia and intra-operative cortico-subcortical electro-stimulation in the surgery for patients with lesions in eloquent areas.Methods Retrospective analysis of 10 patients with lesions in eloquent area,admitted to our hospital from May 2011 to December 2013,was performed.Neuroimaging was used to assess the location of the lesions before surgery,neuron-navigation was used in the craniotomy,awake anesthesia and intra-operative cortico-subcortical electro-stimulation in the surgery of lesions in eloquent areas was performed; and then,total excision of the lesions was adopted.Results Specific motor response was monitored in all the 10 patients accepted cortico-subcortical electro-stimulation,which was matched with that from anterior central gyrus; 5 of them also performed electrophotoluminescence in the language area could be detected with positive reactions.In all 10 patients,total resection was achieved in 8 and subtotal excision in 2.Two patients had transient language dysfunction after operation and got improvement within one week,and recovered to the normal state in three weeks.Myodynamia transitorily decreased in 3 patients after operation and started recovery in one week and achieved the normal state in three month.Perpetual aphasis was noted in all the patients.Conclusion Awake anesthesia and intraoperative direct electrical stimulation were helpful to distinguish lesions from eloquent area,which is a reliable,precise,and safe eloquent area location method; maximum resection of the lesions and minimal damage to the eloquent area can be achieved and the life quality of patients can be improved.