Objective To observe the efficacy and safety of vildagliptin combined with acarbose in treating type 2 diabetes. Methods 78 patients with type 2 diabetes were divided into two groups to have additional vildagliptin combined with acarbose or acarbose combined with placebo. The clinical efficacy and adverse reactions after 12 weeks were investigated. Results In the treatment group, FBG, 2 h PG and HbA1C declined after treatment (P < 0.05) and FCP, 2 h CP, FINS and 2 h INS increased (P < 0.05). Compared with the control group, FBG and HbA1c in the treatment group were reduced and owever, FCP, 2 h CP, FINS and 2 h INS were increased more significantly (P < 0.05). There was no difference in the incidence of overall BMI between the two groups (P > 0.05). There were either liver and kidney damage (P > 0.05), nor hypoglycemia. Conclusion Vildagliptin combined with acarbose is superior to Acarbose combined with placebo , and it produced no more untoward effect.

Objective To explore the cause of secondary QT interval shortening. Method The data of a child with vasovagal syncope and cardiac depression in whom shortened QT interval was induced in head-up tilt test (HUTT) was analyzed retrospectively, and the related literatures were reviewed. Result A 12-year-old boy visited for fainting when brushing his teeth in the morning. ECG showed sinus bradycardia, heart rate at 55 times /min and normal QT and QTc interval. Dynamic electrocardiogram showed sinus rhythm, mean heart rate at 70 times/min, atrial anterior contraction 3 times, normal mean QT and mean QTc. UCG showed approximately normal heart structure and the left ventricular systolic function. There was no abnormality in EEG and cranial CT. His fasting blood glucose was 5.2 mmol/L. The basal tilt test was positive with vasovagal syncope and cardiac depression. During the tilt table test, Holter monitoring showed that sinus arrest occurred in the child when upright tilt for16 min, and then fainted. Time of sinus arrest was 2.9 s and 11.4 s, respectively, and artificial chest compressions were performed. The QT interval was shortened (QT=330 ms), and so was QTc interval (QTc=320 ms). The ratio of QT/QTp was 78% (the lower limit of normal QT interval was 88% of QTp) before sinus arrest occurred. Conclusion Increased vagal tone may induce QT interval shortening.

In this study ,the objective is to establish a nested‐PCR assay for the detection of H .bilis with high sensitivity and specificity .The nested primers were designed based on sequences of 16S rRNA gene of seventeen subtypes of H .bilis .Af‐ter optimizing reaction condition ,the sensitivity and specificity of the assay were examined via the detection of feces simulated samples ,mice infection model samples and clinic patients’ samples .The detection sensitivity of H .bilis strain for feces simu‐lated samples was 10 CFU/100 μL .H .bilis was successfully detected in the liver ,caecum and feces of experimentally infected mice .Moreover ,H .bilis was successfully detected in the bile ,cholecyst mucous membrane and feces samples from two of ten patients with cholelithiasis .Due to the PCR assay’s high sensitivity and specificity ,the method may be used to detect the infec‐tion of H .bilis .

Objective To prepare an experimental encephalomyocarditis virus ( EMCV) vaccine and study its immunogenicity .Methods EMCVs were cultured in Vero cells and viral titer was detected by micro cytopathy method .A series of procedures including concentration , filtration and ultracentrifugation were conducted to purify EMCVs .Formaldehyde and β-propiolactone were used for viral inactivation and their efficacy was evaluated .The median lethal dose ( LD50 ) of EMCV was measured by using Reed-Muench method.The serum antibody titers in BALB/c mice vaccinated with different immunization strategies were analyzed through microneutralization assay .Then the immunized mice were challenged with 100LD50 , 50LD50 and 25LD50 of EMCV by intraperitoneal injection .Results The viruses could be inactivated by β-propiolactone at a volume ratio of 1 ∶4000 for 12 hours at 4℃.The LD50 of EMCV was 17 CCID50/ml.The immunized mice produced neutralizing antibodies and displayed resistance to EMCV infection.Conclusion The experimental EMCV vaccine could induce protective antibodies in mice .

The aim of this study is to explore the tissue distribution of PEGylated puerarin in acute myocardial ischemia model rats. Healthy male SD rats were randomly divided into two groups (30 each). Both were given PEGylated puerarin at a dose of 488 mg x kg(-1). After 5 min of medication, one group was normal rats, another group with acute myocardial ischemia was established by peritoneal injection of 50 mg x kg(-1) isoprenaline. After administration, the animals were executed at 30, 60, 90, 120, 150 and 180 min, then heart, liver, spleen, lung, kidney were extracted. The content of puerarin in organ tissue was determined by HPLC. The results showed that the AUC of tissue distribution of PEGylated puerarin in normal rats was liver > kidney > heart ≈ spleen > lung > brain. While the AUC of tissue distribution of PEGylated puerarin in acute myocardial ischemia model rats was liver ≈ heart > kidney > lung ≈ spleen > brain. AUC(heart) of PEGylated puerarin in acute myocardial ischemia model rats was 1.7 times than that of the normal rats, and there was significant difference (P < 0.05). Thus, PEGylated puerarin had a good heart-targeting property in early myocardial infarction area, drugs could accumulate in the ischemic myocardium. It provided important information for further study and clinic use of PEGylated puerarin.

Objective To explore and develop methods for encephalomyocarditis virus (EMCV) identification.Methods According to the genetic sequence VR-129B of EMCV recorded in the GenBank,five gene fragments were selected to design primer sequence pairs.RNA was extracted to run RT-PCR,and then the products of amplification were identified by agarose gel electrophoresis.The results of DNA sequences were compared with the sequences in GenBank of the same EMCV strains.Antiserum was prepared based on the EMCV cultured in RK cells for establishing indirect immunofluorescence assay (IIFA) and neutralization test method,and verification for precision and specificity of the two methods were carried out after it.Antiserum that was prepared with GST-VP1 and GST-VP2 expressed in E.coli was reacted with the purified EMCV in Western blot test.Results By sequencing and comparing,the similarity of DNA fragments between the obtained and the GenBank recorded was reached 98％ to 100％.The antiserum of No.20100901 batch that was chosen as the first antibody at a dilution of 1 ∶ 160 to develop IIFA brought about a better specificity.The neutralization titers of 20100901 batch antiserum was 1 ∶ 30 211 measured by fixing virus and diluting serum method,which showed good specificity and precision.The results of the Western blot test showed two clear bands above and under 33×103 respectively,which matched the theoretical value.Conclusion The RT-PCR,indirect immunofluorescence,neutralization test and Western blot method for EMCV strains identification were established initially.

Talents are the core driving force to promote the high-quality development of public hospitals,and the talent team building is an important factor for hospitals to get sustainable development and improve comprehensive competitiveness.In view of the shortage of high-level talents,the imperfect talent reserve system,and the lagging personnel management mechanism of public hospitals and the resulting unreasonable talent team structure and talent gap,public hospitals should take talent team building as the starting point,pay equal attention to the introduction and training of talents,interact with discipline construction and talent construction,vigorously promote the construction of personnel management system and mechanism innovation,form a standardized,scientific,refined and efficient modern hospital management system,so that the effectiveness of talents can be max-imized,and provide intellectual support for the high-quality development of public hospitals.

This article reports a patient with typical Cushing syndrome′s manifestations and extremely low plasma cortisol level, indicating glucocorticoid hypersensitivity syndrome. After treatment with the glucocorticoid receptor antagonist mifepristone, the patient′s Cushing symptoms were significantly relieved, and cortisol levels returned to normal. The aim of this report is to enhance clinical awareness among physicians regarding glucocorticoid hypersensitivity syndrome.

Objective:To investigate the changes in N-terminal pro-B-type natriuretic peptide (NT-proBNP) and its role in predicting major adverse cardiac events (MACEs) in patients with end-stage heart failure (ESHF) before and after implanted a HeartCon left ventricular assist device (LVAD).Methods:The retrospective study included 30 ESHF patients [23 males and 7 females, aged 54.5 (40.8, 60.0) years], who were admitted to TEDA International Cardiovascular Disease Hospital from September 15, 2020 to June 20, 2023 to receive treatment with HeartCon LVAD implantation. Their clinical data were analyzed and NT-proBNP concentrations in their blood samples were measured preoperatively and during the follow-up period. Patients were followed regularly and MACEs, including cardiac death and rehospitalization for right heart failure, were recorded within 6 months of discharge; Logistic regression was used for prognostic analysis, and Receiver Operator Characteristic (ROC) curves were used to assess the adjunctive diagnostic value of NT-proBNP for poor prognosis in LVAD patients. The cut-off values for diagnosing poor prognosis by NT-proBNP were divided into two groups, and survival analysis was performed by Kaplan-Meier and tested by log rank; Cox regression was performed to analyze whether high levels of NT-proBNP at 6 months of follow-up wsa a risk factor for poor prognosis in patients with LVAD.Results:The median preoperative NT-proBNP level in 30 ESHF patients successfully implanted with HeartCon LVADs was 3 251.0 (1 544.5, 6 401.5) pg/ml. It decreased significantly 7 days postoperatively (3 251.0 vs. 1 815.0 pg/ml, P<0.05), and then the decreasing trend slowed. It decreased to 1 182.0 (620.0, 3 385.3) pg/ml on the 90th post-operative day. The preoperative NT-proBNP>3 251.0 pg/ml group had a longer postoperative hospital stay (47 d vs 33 d, Z=-2.138, P=0.032). Multivariate logistic regression analysis, only NT-proBNP at 7 days postoperatively was found to predict poor prognosis in LVAD patients, with an OR of 1.001 ( P=0.01); ROC curves were analyzed for the adjunctive diagnostic value of 7-day postoperative NT-proBNP levels for poor prognosis (cut-off value of 2 083.0 pg/ml), with an AUC of 0.833 ( P=0.002); The Kaplan-Meier survival analysis showed that the time to MACEs within 6 months was significantly shorter in the group with NT-proBNP>2 083.0 pg/mL on postoperative day 7 than in the group with NT-proBNP≤2 083.0 pg/ml (3.538±0.689 vs. 5.471±0.323 months, P=0.004); Cox regression analysis showed that the risk of MACEs was 4.25 times higher in the 7-day postoperative NT-proBNP>2 083.0 pg/ml group than in the NT-proBNP≤2 083.0 pg/ml group ( HR=4.25, P=0.035). Conclusions:The higher the preoperative NT-proBNP level, the longer the postoperative hospital stay in HeartCon LVAD patients. NT-proBNP levels decrease most significantly on postoperative day 7 and is a risk factor for MACEs. It may be used as a prognostic predictor in ESHF patients with implanted LVADs.

Objective:To investigate the correlations of endoscopic evaluation results with laboratory indices and clinical disease activity in Crohn disease (CD) patients with different intestinal involvement.Methods:Data of 147 patients diagnosed as having CD who visited the Department of Gastroenterology, Zhongnan Hospital of Wuhan University from July 1, 2017 to June 30, 2022 were collected retrospectively. According to the involvement of intestinal segment, patients were divided into three groups: the group with isolated small intestinal involvement ( n=55), the group with both small intestinal and large intestinal involvement ( n=48), and the group with isolated large intestinal involvement ( n=44). Correlations of endoscopic evaluation (based on CDEIS) with laboratory indices and clinical disease activity (based on Harvey-Bradshaw index) were analyzed. Results:C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) could be used for the prediction of endoscopic disease activity. The areas under curve (AUC) of receiver operator characteristic (ROC) were 0.677 (0.506-0.849) and 0.744 (0.597-0.890), respectively. In terms of determing clinical disease activity, clinical Harvey-Bradshaw index was consistent with endoscopic CDEIS score in 65.3% (96/147) patients, showing a low positive correlation ( r=0.260, P<0.05). In subgroup analysis for patients with isolated small intestinal involvement, CRP showed no predictive value for clinical disease activity [AUC (95% CI): 0.617 (0.461-0.773), P=0.148], while for endoscopic activity neither CRP nor ESR showed predictive value [AUC (95% CI): 0.537 (0.146-0.929), P=0.829; AUC (95% CI): 0.571 (0.153-0.990), P=0.680]. Furthermore, for patients with isolated small intestinal involvement and both small intestinal and large intestinal involvement, no correlation was found between clinical Harvey-Bradshaw index and endoscopic CDEIS score ( r=0.222, P=0.092; r=0.142, P=0.322). Conclusion:For CD patients with small intestinal involvement, especially isolated small intestinal involvement, laboratory indices and clinical disease activity cannot accurately reflect endoscopic disease activity. Great importance should be attached to evaluation of the extent and activity of intestinal lesions by endoscopy, especially enteroscopy.