Part of the patients with transient ischemic attack (TIA) may develop ischemic stroke.Some of them may die because of complicating cardiovascular disease.Studies in recent years have shown that the ABCD2 score has an important value in the evaluation of the prognosis of TIA.This article summarizes the source and application of the ABCD2 score,and focuses on the roles of the score in the evaluation of the prognosis of TIA.

Dipeptidyl peptidase 4 (DPP-4) inhibitors are novel oral hypoglycemic agents, which have been used to inhibit degradation of endogenously released glucagon-like peptide-1 ( GLP-1 ) via inhibiting DPP-4 activity, consequently increasing level of GLP-1 in circulation, enhancing the effect of incretin hormone, and finally leading to improve glucose control. Meta-analysis showed that DPP-4 inhibitors exhibit better glucose-lowering effect in Asians compared with that in Caucasian. The racial differences of hypoglycemic effect could be mainly ascribed to the differences in the frequency of pancreatic-related gene mutations, the severity ofβ-cell dysfunction, the level of GLP-1, and the intake of carbohydrates in patients with diabetes mellitus.

One hundred and forty-five patients with primary aldosteronism (PA) admitted from 2006 to 2013 were enrolled in the study. The diagnosis of PA was confirmed by upright furosemide test and all patients met the following criteria: ① round-or oval-shaped lesion of low density with diameter>1 cm in one adrenal gland shown in contrast CT scan; ② no lesion or abnormality in contralateral adrenal gland; ③serum potassium level<3.5 mmol/L. Of 145 patients, 106 underwent total adrenalectomy, 36 partial adrenalectomy and 3 tumor enucleation. Serum potassium was (2.75±0.55) mmol/L before and (4.03±0.46) after surgery. Potassium was normalized after treatment in 141 cases (97.2％) with correction or improvement in hypertension; 4 patients (2.8％) remained hypokalemic and received spironolactone. Patients with normalized potassium were followed up for a medium period of 74 months (22—103 months), of whom 32 (22.7％) dropped off; the remaining 109 (77.3％) patients did not have hypokalemia. Multivariate linear correlation analysis showed that serum potassium level was negatively correlated with tumor diameter (r=?0.273,95％ CI:?0.086—?0.564, P=0.026) and basal serum aldosterone level (r=?0.261,95％ CI:?0.047— ?0.514, P=0.036). In PA patients with unilateral adrenal macroadenoma and hypokalemia, satisfactory surgical resolution can be achieved without adrenal venous sampling in majority of patients.

Objective　To observe the short-term and long-term effects of leptin on hepatic glucose oxidation and glucokinase gene expression. Methods　Rat hepatic cell line BRL was incubated with leptin of different doses (range from 10?ng/ml-200?ng/ml) for 1?h or 24?h. Glucose oxidation was determined by liquid scintillation counting. Glucokinase gene expression (corrected by β-actin) was determined by reverse transcription semi-quantitative polymerase chain reaction. Results　Treatment with leptin 10?ng/ml for 1?h had no significant effects on glucose oxidation in hepatic cells. However, at the doses ranging from 50?ng/ml to 200?ng/ml, leptin significantly inhibited glucose oxidation. These effects disappeared when the hepatic cells were exposed to leptin for 24?h. Glucokinase mRNA expression was reduced significantly after both 1?h and 24?h exposure to leptin (100?ng/ml) as compared to that of the control group. Conclusion　A low dose of leptin has no significant effect on glucose oxidation in hepatic cells. A relatively high dose of leptin has an acute inhibitory effect on the glucose oxidation in hepatic cells. This effect may likely involve the inhibition of glucokinase gene expression. The inhibitory effect on glucose oxidation is transient and disappears with prolonged exposure time.

Objective:To explore effects of application of inadventent perioperative hypothermia (IPH) cluster nursing in surgical patients, and knowledge, belief and practice of IPH protection among Operating Room nurses.Methods:Using the convenient sampling method, a total of 2 166 surgical patients from Xiangyang Central Hospital from October 2018 to October 2020 were selected as the research objects. A total of 1 123 patients who underwent surgery from October 2018 to October 2019 were set as the control group, and 1 043 patients who underwent surgery from November 2019 to October 2020 were set as the observation group. Fifteen Operating Room nurses were included in the control group and observation group respectively. The nurses in the control group and in the observation group respectively adopted routine heat preservation measures and cluster nursing measures to carry out temperature nursing of surgical patients. The body temperature of patients in the two groups before and after operation were compared, as well as knowledge, attitude and practice questionaire of IPH protection of nurses of the two groups before and after the intervention.Results:The postoperative body temperature of the observation group was (36.51±0.79) ℃, which was higher than that of the control group (34.27±0.76) ℃, and the difference was statistically significant ( P<0.05) . After the intervention, the total score and section scores of nurses in the observation group on knowledge, attitude and practice questionaire of IPH protection were higher than that of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:IPH clustered nursing can reduce the occurrence of IPH in surgical patients and improve the knowledge, belief and practice level of IPH protection among Operating Room nurses.

Objective:To compare the efficacy of endoscopic retrograde appendicitis therapy (ERAT) and sub-endoscopic retrograde appendicitis therapy (SERAT) for the treatment of acute appendicitis.Methods:The retrospective study was performed on consecutive patients who underwent SERAT (21 cases) and ERAT (30 cases) for acute appendicitis in Shandong Provincial Third Hospital from November 2021 to April 2023. Patient baseline information, clinical treatment, hospitalization costs, and hospital stay were analyzed, and complications and recurrence were followed up.Results:There was no significant difference between the two groups regarding age, gender, clinical manifestation, laboratory and imaging data, or Alvrrado score ( P>0.05). Compared with the ERAT group, the operation time was shorter in the SERAT group (23.6±10.1 min VS 44.8±18.8 min, t=4.679, P<0.001). There were no significant differences between the two groups in stent implantation rate [61.9% (13/21) VS 70.0% (21/30), χ2=0.364, P=0.546], fecalith removal rate [38.1% (8/21) VS 33.3% (10/30), χ2=0.123, P=0.726], postoperative time for temperature (19, 2, 0 and 26, 3, 1 cases after 0 to 1 day, >1 to 3 days and >3 days, respectively, χ2=0.723, P=0.697) and white blood cell count normalization (20, 1, 0 and 27, 2, 1 cases after 0 to 1 day, >1 to 3 days and >3 days, respectively, χ2=0.813, P=0.666), proportion of visual analogue scale scores<3 at 6 hours after treatment [100.0% (21/21) VS 90.0% (27/30), χ2=2.231, P=0.135], length of hospital stay (3.4±1.2 days VS 4.5±2.9 days, t=1.579, P=0.121), hospitalization cost (15 393.0±4 352.5 yuan VS 17 836.0±5 134.6 yuan, t=1.777, P=0.082), or incidence of complications [0.0% (0/21) VS 0.0% (0/30), χ2=0.000, P=1.000]. The recurrence rate in SERAT group (0.0%, 0/21) was significantly lower than that in ERAT group (23.3%, 7/30) ( P=0.017). Conclusion:SERAT is a safe and effective minimally invasive approach for managing acute appendicitis, characterized by a shorter operation duration and a lower recurrence rate compared to ERAT.