Objective To investigate the clinical efficacy of DPP-4 inhibitors in the treatment of newly diagnosed type 2 diabetes mellitus and its effect on blood pressure and body weight.Methods A total of 100 newly diagnosed elderly patients with type 2 diabetes mellitus were enrolled in this study from July 2013 to June 2015 in this hospital.They were divided into observation group and control group(n=50).The control group was treated with placebo on the basis of diet control and exercise.The observation group was treated with sitagliptin on the basis of diet control and exercise.Fasting plasma glucose(FPG),2 h postprandial blood glucose(2 h PG) and glycated albumin (GA) were measured before and after treatment,and the incidence rate of hypoglycemia,blood pressure,body weight and other adverse reactions were monitored.Results After treatment,two groups of patients,condition were significantly improved,FPG,2 h PG,GA changes in observation group were significantly better than that of control group,the difference were statistically significant(P＜0.05).There was no significant difference in blood pressure,body weight and body mass index before and after treatment,and also between the two groups(P＞0.05).The incidence of adverse reactions in the observation group and the control group were 10.0％ and 8.0％,The incidence of adverse reactions in the two groups was not statistically significant(P＞0.05).Conclusion The clinical efficacy of DPP-4 inhibitor siglitazide in the treatment of newly diagnosed elderly patients with type 2 diabetes mellitus is good,and it is very useful in the treatment of these patients.

Objective To study the expression and clinical significance of anty-apoptosis protein BAG-1 in non-small cell lung cancer(NSCLC),and its relationship with cell apoptosis and expression of Bcl-2 protein. Methods Immunohisto chemistry streptavidin-peroxidase conjugated (SP)method was used to examine the expression of BAG-1protein and Bcl-2 protein,and terminal deoxynucleotidyl transferase mediated UTP nick end labeling(TUNEL) method was used to examine the apoptosis index in 54 cases of NSCLC.The expression of BAG-1 protein in 20 cases of normal bronchus mucosa tissue also be detected as control. Results Express positive rate of BAG-1 protein in NSCLC is 74.07%,obviously higher than that in normal bronchus mucosa tissue(positive rate is 5%).In cases of NSCLC,the expression of BAG-1 protein has not correlation with the age,gender,pathologic classification,but have closed correlation with lymph node metastasis,degree of differentiation,pTNM stage(P

Objective To detect the antibodies against recombinant chlamydial plasmid-encoded protein 3(rPgp3),chlamydial protease-like activity factor(rCPAF),Ct143 encoded protein(rCT143), Ct101 encoded protein(rCT101),Ct694 encoded protein(rCT694),Ct813 encoded protein(rCT813), Chlamydia membrane protein A(rIncA),Ct875 encoded protein(rCT875),major outer membrane protein (rMOMP)and heat shock protein 60( rHsp60)in serum samples collected form patients with urogenital Chlamydia trachomatis(Ct)infection and to evaluate the antigenicity of those proteins. Methods The re-combinant plasmids expressing the 10 proteins and a blank plasmid were transformed into E. coli BL21 strains,respectively. The transformed E. coli BL21 strains were induced by isopropyl β-D-1-thiogalactopyr-anoside(IPTG)to express recombinant proteins. The glutathione pre-coated 96-well ELISA plates were coa-ted with lysates. Serum samples were collected from 50 patients with Ct infection and 10 patients without Ct infection. ELISA was performed to detect the antibodies against 10 recombinant proteins. Results The anti-bodies against rPgp3,rCPAF,rCT143,rCT101,rCT694,rCT875,rCT813,rMOMP,rIncA and rHsp60 proteins were respectively detected in 44 cases(88% ),38 cases(76% ),37 cases(74% ),36 cases (72% ),33 cases(66% ),31 cases(62% ),30 cases(60% ),26 cases(52% ),24 cases(48% )and 17 cases(34% )out of 50 serum samples. No antibodies against 10 recombinant proteins were detected in the serum samples collected from patients without Ct infection. Conclusion The rPgp3 protein showed the strongest antigenicity among all of the studied proteins,followed by rCPAF and rCT143 proteins. The rHsp60 protein showed the lowest antigenicity.

Objective To verify the detection ability of experimental animal quality detection laboratories in China for Staphylococcus aureus.Methods The testing samples for Staphylococcus aureus detection were prepared by bacterial culture, homogeneity test and stability test, according to the study plan approved by CNAS.Then the samples and operation instruction were sent to the participant laboratories.The detection reports from these laboratories should be submitted before the deadline expires, and the collected data were summarized and analyzed.Results There were 28 laboratories which joined to this test plan.Among them 22 laboratories ( 78.57%) achieved satisfactory test results, and six laboratories (21.43%) had unsatisfactory test results.27 Laboratories used the national standard detection assay, while only one labo-ratory used PCR assay.Conclusions Most of experimental animal quality testing laboratories in China have sufficient pro-ficiency in detection of Staphylococcus aureus.The obtained information are very helpful for the laboratory ability verification testing in future.

Objective To optimize immunodominant protein combinations for serological screening for Cblamydia trachomatis (Ct) infection.Methods Both serum and genital swab samples were collected from 50 patients with Ct infection confirmed by colloidal gold immunochromatographic assay (GICA),and 30 GICA-negative clients without Ct infection at a sexually transmitted disease (STD) clinic in Tianjin Medical University General Hospital.The 30 serum samples from GICA-negative clients were also negative for microimmunofluorescence (MIF) assay.Eight Ct immunodominant proteins,including Pgp3,CPAF,CT143,CT101,CT694,CT875,CT813 and IncA,were selected as antigens to detect corresponding antibodies in the serum samples by enzyme-linked immunosorbent assay (ELISA) with the Ct proteins Hsp60 and major outer membrane protein (MOMP) as references.The results of ELISA were compared with those of the traditional gold standard method MIF assay to determine the immunodominant protein combination with the highest sensitivity and specificity.Results Of the 50 serum samples from patients with Ct infection,44 were positive and 6 negative by MIF.The results of ELISA with the combination of immunodominant proteins Pgp3,CT694 and CT875 as antigens were 97.73％ (43/44) consistent to those of MIF assay.Of the 30 serum samples from GICA-negative clients,all were negative by MIF.Meanwhile,no antibody was detected against any of the immunodominant proteins Pgp3,CT694 and CT875 in any of the serum samples from GICA-negative clients.Conclusions The ELISA with the combination of immunodominant proteins Pgp3,CT694 and CT875 as antigens has good sensitivity and specificity for serological screening for Ct infection,and is simple to operate and easy to popularize.

Objective To evaluate the clinical application value of reflectance confocal microscopy(RCM) in the diagnosis of several common diseases manifesting as papules in children, including lichen nitidus, verruca planae, lichen striatus, milium, molluscum contagiosum and lichen pilaris. Methods A total of 579 children clinically characterized by papules were recruited into this study. RCM was used to observe lesions and perilesional normal skin. The RCM features of 6 diseases manifesting as papules were analyzed and compared. Results Based on RCM images, 236 patients were diagnosed with lichen nitidus, 70 with verruca planae, 123 with lichen striatus, 40 with milium, 53 with molluscum contagiosum and 57 with lichen pilaris. All the 6 diseases had typical RCM features. Concretely speaking, RCM images of lichen nitidus lesions showed infiltration of dense inflammatory cells and melanophages in enlarged dermal papillae. In RCM images of verruca planae lesions, cells in the granular and spinous layers were arranged in concentric circles, giving a rose cluster?like appearance. RCM images of lichen striatus lesions revealed focal swelling of stratum spinosum, absent or local liquifaction degeneration of basal cells, and clustering of a moderate number of inflammatory cells in the superficial dermis. In RCM images of milium lesions, well?circumscribed round or oval structures containing highly but nonuniformly refractive materials could be seen in the dermis. RCM images of molluscum contagiosum lesions showed intact cystoid structures containing highly refractive molluscum bodies. Lowly to moderately refractive cutin ? like materials were observed along with the dilation of hair follicle infundibula in RCM images of lichen pilaris lesions. In RCM images, the 6 diseases were distinguished mainly based on structural features(patterns and refractivity)of skin lesions shown by continuous vertical scanning. Conclusion RCM is of great value to the diagnosis of diseases manifesting as papules in children.

Objective:To explore the application of GLTC (goodwill, listening, talking, and cooperation) doctor-patient communication mode combined with case-oriented teaching in prosthodontics practice teaching.Methods:Thirty undergraduates majoring in stomatology who practiced in West China/Hospital of Stomatology, Sichuan University from July 2019 to July 2020 were selected and randomly divided into the control group ( n=15) and the observation group ( n=15). The control group used the case-oriented teaching, and the observation group adopted the GLTC doctor-patient communication mode combined with the case-oriented teaching. The performance of clinical practice (theoretical performance, medical record analysis performance, operation performance, lecture performance), interns' doctor-patient communication ability, and interns' teaching subjective evaluation of the two groups were evaluated. SPSS 22.0 was used for t-test and Chi-square test. Results:The theoretical performance, medical record analysis performance, operation performance, and lecture performance of the interns in the observation group were better than those in the control group ( P < 0.05). The score of Liverpool doctor communication ability evaluation scale in the observation group was higher than that in the control group ( P<0.05). In the subjective evaluation of the teaching mode of the interns, the improvement of learning interest, collective awareness, language expression ability, comprehensive analysis ability, and clinical operation ability in the observation group were better than those in the control group ( P<0.05). Conclusion:The GLTC doctor-patient communication model combined with the case-oriented teaching method is effective in prosthodontics practice teaching, which can effectively improve the professional knowledge and skills of interns and improve their teaching satisfaction and doctor-patient communication ability.

Objective:To probe into the potential prognostic value of lymphocyte subsets in gastric cancer.Methods:This study included patients who underwent radical gastrectomy for gastric cancer from Aug 2014 to Dec 2016. The immunological differences was analyzed in different infiltration patterns. The overall survival of patients was analyzed by Kaplan-Meier method and Log-rank test. COX regression was performed to assess independent prognostic factors of the patients, and finally constructed nomogram.Results:The median number of peripheral CD4 and CD19 cells in infiltration pattern c was 750 (94-2 504) cells/μl and 186 (17-820) cells/μl; the median number of peripheral CD4 and CD19 cells in infiltration pattern a was 802 (203-2 071) cells/μl and 213 (5-948) cells/μl, the number of peripheral CD4,CD19 cells in infiltration pattern c was lower than that in infiltration pattern a, with statistically significant differences (CD4: Z=-3.061, P=0.002; CD19: Z=-2.016 , P=0.044). CD19 lymphocytes ( P=0.023) were associated with infiltration pattern a, CD8 lymphocytes ( P=0.027) were associated with infiltration pattern b, and CD4 lymphocytes ( P=0.026) were independent risk factors associated with the prognosis of infiltration pattern c. A nomogram can be constructed to evaluate the prognosis of patients. Conclusion:There are differences in the number of peripheral lymphocyte subsets in patients with different INF types. A nomogram can be constructed from lymphocyte subsets and clinicopathological features to assess patient prognosis.

Objective To investigate the prevalence of common thyroid diseases and urinary iodine levels in the population migrated from inland to coastal areas and to evaluate the epidemiological trend of thyroid disease in Heibei Cangzhou. Methods A retrospective analysis method was adopted. All the persons who were employees of enterprises and institutions,were divided into three groups:the migrated group,who migrated from Cangzhou City and the west counties of Cangzhou City to the Port of Huanghua where they had settled permanently because of the job; the inland group, who lived in Cangzhou City all the time and the seaport group, who lived in the Port of Huanghua for a long-term. Migrated groups were divided into stable occupants and intermittent occupants. During 2010 - 2016, a follow-up survey was conducted in the three groups at Examination Center of Cangzhou Central Hospital Physical. We compared the cumulative incidences of thyroid diseases including: chronic lymphocytic thyroiditis (CLT), nodular thyroid disease and Graves's disease (GD). In migrated group, 28 persons who occasionally lived in the Port of Huanghua were detected urinary iodine levels intermittently.We compared the two parts of urinary iodine level changes for three times by collecting a urine sample,including one part from people who lived in the Port of Huanghua continuously for more than a month,and another part of people who lived in Cangzhou or Hejian County for more than half a month then returned to Port of Huanghua. Results In 2010 - 2016, a total of 7 180 residents were surveyed, of which 2 012 were in the migrated group, 2 858 were in the inland group and 2 310 in the seaport group. The incidences of CLT and nodular thyroid disease were 2.29% (46/2 012)and 8.60% (173/2 012)in the migrated group,which were much higher than that of the inland group and the seaport group [1.05% (30/2 858), 5.42% (155/2 858); 1.47% (34/2 310), 6.88% (159/2 310), P < 0.01 or < 0.05]. At the same time,the incidences of GD was 0.45%(9/2 012) in the migrated group, which was higher than that of the inland group [0.10% (3/2 858), P < 0.05]. In migrated group, there were 1 503 residencies, including 482 stable occupants and 1 021 intermittent residents. The incidences of CLT and nodular thyroid disease in intermittent residents were 3.23% (33/1 021) and 9.89% (101/1 021), which were much higher than that of stable occupants [1.45% (7/482), 6.64% (32/482), P < 0.05]. The urinary iodine levels in the persons who lived in the Port of Huanghua occasionally (464.6 μg/L) were much higher than that of the persons who lived in Cangzhou for a long time(301.4 μg/L, U = 4.648, P < 0.01).There was a marked fluctuation of the median of urinary iodine determined 6 times which were 485.7,285.2,431.7,310.6,470.3 and 304.4 μg/L,respectively.Conclusions The incidence of many thyroid diseases of people migrated from inland to coastal areas has increased, which is not only higher than that of inland people,but also higher than that of coastal people.Large fluctuations in iodine intake due to migration flow and residential instability may be part of the reason for the high incidence of thyroid diseases. In the future, we should pay more attention to thyroid diseases of migratory population.

Objective:To construct a prediction model of pancreatic fistula after pancreaticoduodenectomy and explore its application value.Methods:The retrospective case-control study was conducted. The clinicopathological data of 285 patients with periampullary diseases who underwent pancreaticoduodenectomy in the the First Affiliated Hospital of Harbin Medical University from January 2015 to September 2018 were collected. There were 183 males and 102 females, aged (56±14)years, with a range from 12 to 84 years. According to the random numbers showed in the computer, patients were randomly divided into training dataset consisting of 214 patients and validation dataset consisting of 71 patients, with a ratio of 3∶1. The training dataset was used to construct prediction model, and the validation dataset was used to evaluate performance of prediction model. Observation indicators: (1) incidence of postoperative pancreatic fistula; (2) construction of prediction model of pancreatic fistula after pancreaticoduodenectomy; (3) validation of prediction model of pancreatic fistula after pancreaticoduodenectomy. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed by the t test. Measurement data with skewed distribution were represented as M (range), and comparison between groups was analyzed using the Mann-Whitney rank sum test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test. Univariate analysis and multivariate analysis were conducted using the Logistic regression model. The accuracy of prediction model was analyzed by drawing receiver operating characteristic curve and calculating area under curve (AUC). Results:(1) Incidence of postoperative pancreatic fistula: of 214 patients in the training dataset, 45 patients had postoperative pancreatic fistula, including 39 of grade B and 6 of grade C, respectively. (2) Construction of prediction model of pancreatic fistula after pancreaticoduodenectomy. Results of univariate analysis showed that body mass index(BMI), diameter of the main pancreatic duct on computed tomography (CT) scan, diameter of the main pancreatic duct by intraoperative exploration, pancreas texture, and level of amylase in ascites at the postoperative first day were related factors for pancreatic fistula after pancreaticoduodenectomy ( χ2=32.450, 15.789, 19.577, 4.559, Z=-7.962, P<0.05). Results of multivariate analysis showed that BMI>25 kg/m 2, diameter of the main pancreatic duct by intraoperative exploration <3 mm and level of amylase in ascites at the postoperative first day >2 651U/L were independent risk factors for pancreatic fistula after pancreaticoduodenectomy ( odds ratio=0.148, 4.286, 0.086, 95% confidence interval: 0.058-0.376, 1.736-10.580, 0.032-0.231, P<0.05). Based on results of multivariate analysis, a prediction model of pancreatic fistula after pancreaticoduodenectomy was built: the predicted value of pancreatic fistula=Exp[0.452-1.914(BMI)+ 1.455(diameter of the main pancreatic duct by intraoperative exploration)-2.451(level of amylase in ascites at the postoperative first day)]/1+ Exp[0.452-1.914(BMI)+ 1.455(diameter of the main pancreatic duct by intraoperative exploration)-2.451(level of amylase in ascites at the postoperative first day)]. The model had the AUC of 0.888 (95% confidence interval : 0.832-0.943, P<0.05). (3) Validation of prediction model of pancreatic fistula after pancreaticoduodenectomy: in the validation dataset, the prediction model of pancreatic fistula after pancreaticoduodenectomy had the AUC of 0.868 (95% confidence interval: 0.780-0.957, P<0.05). There was no significant difference in the AUC between the training dataset and validation dataset ( Z=0.514, P>0.05). Conclusions:BMI>25 kg/m 2, diameter of the main pancreatic duct by intraoperative exploration <3 mm and level of amylase in ascites at the postoperative first day >2 651 U/L are independent risk factors for pancreatic fistula after pancreaticoduodenectomy. Construction of a prediction model of pancreatic fistula after pancreaticoduo-denectomy can effectively predict the risks of postoperative pancreatic fistula.