This study was conducted to evaluate the relationship between serum insulin levels and the production of insulin antibody (IA) in type 2 diabetes (T2DM).A total of 647 T2DM were included.Among them,20.9％ patients were IA positive,who were elder and had a longer duration,lower BMI,a higher positive rate of glutamic acid decarboxylase antibody(GADAb) and higher serum insulin levels during an insulin secretion test.More patients were treated with insulin in IA positive group than in IA negative group (65.9％ vs 41.0％,P =0.000).Fasting serum insulin level was associated with occurrence of IA in all patients (OR =1.02,P =0.001) and insulin treated patients (OR =1.033,P =0.002).The cut-off point of fasting serum insulin level for predicting IA positive was 17.87 mIU/L (sensitivity 55.1％,specificity 89.0％).Exogenous insulin use is associated with the presence of IA.Fasting serum insulin level can be used as a predictor for the production of IA in insulin-treated patients.

Objective To evaluate the cumulative irritative effect of topical retinoic acid preparations on normal skin.Methods A randomlized,doubled blind,placebo-controlled clinical trial was carried out with7groups for6tested preparations.All subjects were patch tested with each preparation for24hours on Monday to Thursday,and for72hours on Friday.The patch tests were performed for3consecutive weeks.Results The minimal cumulative irritative effects were found in Group G treated with0.1%adapalene gel,with a cumulative irritative index of0.09?0.11in20days.The cumulative irritative index was significantly lower in Group G than that in Group B treated with0.1%retinoic acid(Diweishuang誖)(0.59?0.24),or in0.025%retinoic acid(Diweishuang誖)(0.41?0.22),or in0.05%retinoic acid(VITAMIN誖Cream)(0.25?0.22).Conclusion Adapalene,the third generation of retinoic acid,is characterized by lower irritative ef-fects in comparison to the first generation of topical retinoic acid agents.

Objective To assess the antimicrobial actitivity of econazole nitrate in comparison with other six antibacterial drugs. Methods The minimal inhibitory concentrations (MICs) of econazole nitrate (Eco), neomycin (Neo), erythromycin (E), penicillin (P), cefotaxime sodium (Cef), ciprofloxacin (Cip) and amikacin (An) to 222 strains of Staphylococcus spp isolated from the lesions of patients with eczema and atopic dermatitis were determined by using the broth dilution method. Results MIC50 values of Eco were similar to Neo, Cip, An and Cef, and lower than those of P and E on methicillin-sensitive Staphylococcus aureus (MSSA); significantly lower than those of the other six antibacterial drugs on methicillin-resistant Staphylococcus aureus (MRSA); similar to An, Cip and P, and lower than those of Neo, Cef and E on methicillin-sensitive and coagulase-negative Staphylococcus (MSCNS); and similar to An, Cip P or Neo, and lower than Cef and E on methicillin-resistant and coagulase negative Staphylococus (MRCNS). Based on the NCCLS standards, the resistance rates of Cip, P and E were very high to either Staphylococcus areus or coagulase-negative Staphylococcus (CNS). The resistance rates of An and Cef of were lower to MSSA, but higher than 50% to MRSA. MIC90 value of Eco was similar to its MIC50, and lower than the MIC value reported in the literature. The MIC90 value of neomycin was muich higher than the MIC50 value of econazole. Conclusion Econazole nitrate has antibacterial activity to both Staphylococcus areus and CNS. MIC90 value of Eco is similar to its MIC50, and no resistance to Eco was found.

Objective To investigate the medical assistance to inpatients from low-income families for solving their difficulties in seeing doctors and affordability.Methods Random sampling was made to five ongoing medical assistance projects in the hospital for statistics and analysis of the data so collected.Results Medical expenses of such inpatients are beyond their affordability.Despite the coverage of their basic medical insurance,the reimbursement rate is too low to alleviate their financial burden.Conclusion A“4-party payment”model is recommended,combining the government support for basic medical insurance,social welfare assistance,philanthropic assistance and that paid by the inpatients.This model is expected to effectively alleviate the financial burden of such inpatients.

To analyse the familial aggregation and genetic predisposition of Shen-yin deficiency syndrome (SYDS) in families with diabetes mellitus type 2 (DM2). Methods One hundred and forty-one DM2 patients were collected from 32 family lines in Nanjin area, in which the probands were differentiated as DM2 with SYDS. On them, genetic analysis on the characteristics of SYDS was conducted using pedigree analysis, morbidity and heritability of the first-degree relatives of the probands were calculated, and the action of familial SYDS factor on the genesis of the syndrome was assessed by multiple factors regression analysis. Results The morbidity rate of SYDS in the first-degree relatives of the probands was 33.71%, and the heritability, calculated by Falconer formula, was 80.6%. The fitting result of regression analysis showed that familial factor played an important role in SYDS genesis (OR = 5.61, P = 0.001), but DM2 itself is not an independent risk factor for it. Conclusion DM2 with SYDS shows the tendency of familial aggregation and genetic predisposition, genetic factor is associated with the genesis of the syndrome. Pedigree research is a good method for exploring the relationship between syndrome and genetic factor.
Adult ; Diabetes Mellitus, Type 2 ; genetics ; Diagnosis, Differential ; Female ; Genetic Predisposition to Disease ; Humans ; Male ; Medicine, Chinese Traditional ; Pedigree ; Yin Deficiency ; genetics

Objective To explore the application values of fixed tube current based on head circumference(HC)in children's head CT examinations.Methods A total of 573 children's head CT imaging data were collected retrospectively,the tube current and HC were recorded.Pearson's correlation analysis was used to determine the relationship of tube current with HC,counted the median tube current values of each group based on HC and used them as the prefixed tube current.Seventy-two children were prospectively collected.According to the random number table method,the children were divided into the control group and the experimental group,with 35 cases in the control group and 37 cases in the experimental group.The control group used automatic exposure control(AEC)technology for tube current,while the experimental group used the median value of tube current corresponding to HC group-ing.The difference in radiation doses and image qualities between the two groups was compared.Results Pearson analysis of 573 retrospec-tive cases showed that the correlation between HC and tube current was considerably strong(r=0.95,P＜0.001).The median tube current values of each group based on HC were 70-130 mAs.There were statistically significant differences in CTDIvol.16 and SSDEDW based on water equivalent diameter(DW)between the two groups(t=-11.27,2.81,P＜0.05).Compared with the control group,CTDIvol.16 and SSDEDW in the experimental group decreased by 10.83％and 12.59％respectively.There were no statistically signifi-cant differences in signal-to-noise ratio(SNR)between the two groups(t=-1.26,P＞0.05)and there were also no statistically significant differences in the subjective evaluation of images(Z=-0.45,P＞0.05).Conclusion Measuring children's HC before examination and setting the fixed tube current corresponding to HC grouping can reduce radiation doses while maintaining image qualities.

Objectives:To investigate the effect of cardiac rehabilitation exercise guided by cardiopulmonary exercise test on cardiopulmonary function, cardiopulmonary endurance and activities of daily living in patients who had coronary heart disease after percutaneous coronary intervention (PCI).Methods:Seventy patients who had coronary heart disease after PCI treated in the Wenzhou Central Hospital from July 2022 to May 2023 were enrolled perspectively (3 cases eventually dropped out of the study), and they were divided into the control group (33 cases) and the rehabilitation group (34 cases) by random number table method. The control group was given conventional medication after PCI, while the rehabilitation group was additionally provided with exercise rehabilitation for 12 weeks on the basis of the control group. The patient′s cardiopulmonary function indicators, cardiopulmonary endurance indicators and ability of daily living(ADL) score of the two groups were compared before and after treatment.Results:After treatment for 12 weeks, the cardiopulmonary function indicators left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left atrial inner diameter (LAD), left ventricular end-diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), forced expiratory volume in the first second (FEV 1), ratio of FEV 1 to forced expiratory volume (FVC) (FEV 1/FVC), maximum ventilation quantity (MVV) in the rehabilitation group were obviously improved compared with the control group: (102.8 ± 14.4) ml vs. (114.8 ± 20.4) ml, (39.9 ± 13.7) ml vs. (48.4 ± 16.9) ml, (37.1 ± 3.4) mm vs. (38.9 ± 3.6) mm, (50.3 ± 3.6) mm vs. (52.5 ± 4.7) mm, (64.0 ± 6.8)% vs. (59.6 ± 6.5)%, (2.39 ± 0.38) L vs. (2.10 ± 0.26) L, (77.7 ± 4.0)% vs. (73.8 ± 4.3)%, (101.6 ± 18.7) L/min vs. (89.6 ± 11.1) L/min, there were statistical differences ( P<0.05). After treatment for 12 weeks, the cardiopulmonary endurance indicators peak oxygen uptake (VO 2peak), peak oxygen uptake per kilogram of body weight (VO 2peak/kg), anaerobic threshold (AT), peak metabolic equivalent (METspeak), maximum working load (MWL) in the rehabilitation group were obviously improved compared with the control group: (1 441.8 ± 251.9) ml/min vs. (1 272.5 ± 207.0) ml/min, (20.7 ± 3.6) ml/(min·kg) vs. (18.2 ± 2.5) ml/(min·kg), (1 346.8 ± 201.3) ml/min vs. (1 075.4 ± 176.7) ml/min, (5.9 ± 1.1) Met vs. (5.2 ± 0.7) Met, (107.3 ± 29.1) Watt vs. (88.4 ± 17.8)Watt, there were statistical differences ( P<0.05). After treatment for 12 weeks, the ADL scores in the rehabilitation group was higher than that in the control group: (90.9 ± 8.1) scores vs. (85.6 ± 11.6) scores, there was statistical difference ( P<0.05). Conclusions:Carrying out cardiac rehabilitation exercise guided by cardiopulmonary exercise test can significantly enhance the cardiopulmonary function, cardiopulmonary endurance and self-care ability in patients who had accepted PCI for coronary heart disease.

Objective To compare the early stage immune reconstitution of high-and standardrisk Philadelphia chromosome-negative acute lymphoblastic leukemia (ALL) CR1 patients who had haploidentical blood and marrow stem cell transplantation (HBMT).Methods A total of 49 Ph-negative ALL CR1 patients who received HBMT and had complete early stage immune reconstitution data(+30,+60 and +90 d post transplantation) from Jan.2010 to Dec.2012 were enrolled.Immunophenotyping for B and T lymphocytes was performed post HBMT via flow cytometry.Fresh peripheral blood cells were stained with fluorochrome-labeled monoclonal antibodies against cluster of differentiation CD19,CD3,CD4,CD8,CD45RO,CD45RA and CD28.The early reconstitution of lymphocyte subsets,survival and prognosis between standard-risk group,high-risk adult group and high-risk children group were compared.Results There were no significant differences in all these T lymphocyte subsets among three groups at the three check points (P＞0.05).Moreover,at the same time,comparable outcome had been achieved between standard-risk group (n=18),high-risk adult group (n=16) and high-risk children group (n=15).There were no differences in 2-y relapse incidence (27.8％ vs 31.3％ vs 26.7％,P=0.957),2-y non-relapse mortality (11.1％ vs 0 vs 13.3％,P=0.185),2-y leukemia free survival (61.1％ vs 68.8％ vs 60.0％,P=0.834) and overall survival (77.8％ vs 68.8％ vs 60.0％,P=0.529) among the three groups.Incidence of grade Ⅱ-Ⅳ aGVHD was 44.4％ vs 12.5％ vs 46.7％(P=0.075) and incidence of cGVHD was 61.1％ vs 50.0％ vs 40.0％ (P=0.249).Conclusion Comparison of immune reconstitution at early stage may be a reasonable cause to explain that equivalent outcomes were observed among high-and standard-risk Ph-negative ALL CR1 patients after HBMT.

Deoxyribonucleic acid (DNA) not only serves as the material basis of biological inheritance, but also shows great potential in the development of novel biological materials due to its programmability, functional diversity, biocompatibility and biodegradability. DNA hydrogel is a three-dimensional mesh polymer material mainly formed by DNA. It has become one of the most interesting emerging functional polymer materials in recent years because of the perfect combination of the DNA biological properties that it retained and the mechanical properties of its own skeleton. At present, single- or multi-component DNA hydrogels developed based on various functional nucleic acid sequences or by combining different functional materials have been widely used in the field of biomedicine, molecular detection, and environmental protection. In this paper, the development of preparation methods and classification strategies of DNA hydrogels are summarized, and the applications of DNA hydrogels in drug delivery, biosensing and cell culture are also reviewed. Finally, the future development direction and potential challenges of DNA hydrogels are prospected.
DNA/genetics* ; Drug Delivery Systems ; Hydrogels ; Polymers