Objective To compare the blood glucose level and associated hypoglycemia risks between group of insulin glargine combined with repaglinide and group of mixed insulin in the treatment of type 2 diabetes in the elderly. Methods Sixty four type 2 diabetes patients (age≥60 years) with inadequate glyeaemic control by drugs were divided into 2 groups randomly: glargine group (32 cases) and mixed insulin group (32 cases). In glargine group, 32 patients were given repaglinide before breakfast, lunch, supper respectively and injection of glargine hypodermically once at 22 o'clock every night, while the 32 patients in mixed insulin group were injected with the mixed insulin (Novolin 30R) hypodermically before breakfast and supper respectively for 16 weeks. The dose of repaglinide and insulin were adjusted every 3 days according to the level of fasting glucose (FPG)and postprandial glucose (PPG), reaching the aim of FPG less than 7.2 mmol/L and PPG less than 10mmol/L. The blood glucose level and the incidence of hypoglycemia were observed. Results The daily glucose profile and the level of HbAlc of the 2 groups dropped obviously after 16 weeks treatments (all P<0. 05). At the end of the experiment, the PPG of lunch and supper, and the level of HbAlc were markedly lower in glargine group than in mixed insulin group (all P<0. 05), and the body mass index (BMI) increased markedly in mixed insulin group compared with pre-experiment (P<0. 05), but no significant change was found in glargine group (P>0. 05). The incidence of hypoglycemia in glargine group was lower than that in mixed insulin group (2 patients in glargine group, 12 patients in mixed insulin group, P<0.05). Conclusions Both of the mixed insulin and glargine combined with repaglinide have visible effects on controlling the blood glucose, but the latter has better efficacy, lower risk of hypoglycemia and lower increase of BMI than the former.

This study sought to quantify normal human tibio-femoral joint kinematics in vivo. An eligible volunteer (a man in good health) was recruited, and a technical method of 3D image registration and coordinate transformation was used. The 3D point cloud models of his knee-flexion were illustrated by computed tomography. By use of the technique for 3D image registration, different models of several positions of knee-flexion were aligned to the same coordinate system. As for each model of the knee, the object coordinates of femur and tibia were built on the same location and direction in comparison with individual femur and tibia. Consequently, the error of constructing the object coordinate system in various coordinate systems can be avoided. Meanwhile, improved orthogonal coordinates systems were built on femur, tibia and patella. After orthogonal coordinates were built on each part of the knee, the Euler angle coordinate transformation was applied to acquire the data of the knee relative kinematics. Additionally, the data was proved to be effective, compared with that of recent literatures. With this method, arbitrary reference coordinates, or any alternative reference mode could be used in reconstruction of knee 3D kinematics images on a computer, and be applied in the kinematical analysis of other human joints or bones.
Femur ; anatomy & histology ; Humans ; Imaging, Three-Dimensional ; methods ; Kinetics ; Knee Joint ; anatomy & histology ; physiology ; Male ; Range of Motion, Articular ; physiology ; Tibia ; anatomy & histology ; Tomography, X-Ray Computed

Clonorchis sinensis habitating in the bile duct of mammals causes clonorchiasis endemic in East Asian countries. Parkin is a RING-between-RING protein and has E3-ubiquitin ligase activity catalyzing ubiquitination and degradation of substrate proteins. A cDNA clone of C. sinensis was predicted to encode a polypeptide homologous to parkin (CsParkin) including 5 domains (Ubl, RING0, RING1, IBR, and RING2). The cysteine and histidine residues binding to Zn2+ were all conserved and participated in formation of tertiary structural RINGs. Conserved residues were also an E2-binding site in RING1 domain and a catalytic cysteine residue in the RING2 domain. Native CsParkin was determined to have an estimated molecular weight of 45.7 kDa from C. sinensis adults by immunoblotting. CsParkin revealed E3-ubiquitin ligase activity and higher expression in metacercariae than in adults. CsParkin was localized in the locomotive and male reproductive organs of C. sinensis adults, and extensively in metacercariae. Parkin has been found to participate in regulating mitochondrial function and energy metabolism in mammalian cells. From these results, it is suggested that CsParkin play roles in energy metabolism of the locomotive organs, and possibly in protein metabolism of the reproductive organs of C. sinensis.
Amino Acid Sequence ; Animals ; Clonorchis sinensis/*enzymology ; Cluster Analysis ; Conserved Sequence ; DNA, Complementary/genetics ; Energy Metabolism ; Gene Expression Profiling ; Mitochondria/metabolism ; Models, Molecular ; Molecular Weight ; Phylogeny ; Protein Conformation ; Sequence Homology, Amino Acid ; Ubiquitin-Protein Ligases/chemistry/*genetics/*metabolism

Clonorchis sinensis habitating in the bile duct of mammals causes clonorchiasis endemic in East Asian countries. Parkin is a RING-between-RING protein and has E3-ubiquitin ligase activity catalyzing ubiquitination and degradation of substrate proteins. A cDNA clone of C. sinensis was predicted to encode a polypeptide homologous to parkin (CsParkin) including 5 domains (Ubl, RING0, RING1, IBR, and RING2). The cysteine and histidine residues binding to Zn2+ were all conserved and participated in formation of tertiary structural RINGs. Conserved residues were also an E2-binding site in RING1 domain and a catalytic cysteine residue in the RING2 domain. Native CsParkin was determined to have an estimated molecular weight of 45.7 kDa from C. sinensis adults by immunoblotting. CsParkin revealed E3-ubiquitin ligase activity and higher expression in metacercariae than in adults. CsParkin was localized in the locomotive and male reproductive organs of C. sinensis adults, and extensively in metacercariae. Parkin has been found to participate in regulating mitochondrial function and energy metabolism in mammalian cells. From these results, it is suggested that CsParkin play roles in energy metabolism of the locomotive organs, and possibly in protein metabolism of the reproductive organs of C. sinensis.
Amino Acid Sequence ; Animals ; Clonorchis sinensis/*enzymology ; Cluster Analysis ; Conserved Sequence ; DNA, Complementary/genetics ; Energy Metabolism ; Gene Expression Profiling ; Mitochondria/metabolism ; Models, Molecular ; Molecular Weight ; Phylogeny ; Protein Conformation ; Sequence Homology, Amino Acid ; Ubiquitin-Protein Ligases/chemistry/*genetics/*metabolism

Objective To investigate the nursing highlight of different contrast medium to detect gastric lesions by spectral CT.Methods A total of 150 patients with gastric cancer were averagely divided into experimental group and control group according to coin toss.The 20 ml iohexol mixed with 1 500 ml warm water were used in the experimental group,but only oral warm water was used in the control group.The monitored result of gastric cancer,adverse reactions and appropriate care were evaluated.Results The corrective rate of spectral CT for gastric cancer detection in the experimental group and control group were 96.0％ and 85.3％ respectively,and the difference was significant (x2 =5.042,P ＜ 0.05).Meanwhile,the proportion of adverse reactions in the experimental group and control group were 10.7％ (8/75) and 6.7％ (5/75),but the difference was not statistically significant (x2 =0.785,P ＞ 0.05).However,73.3％ patients in the experimental group underwent anxiety or depression,which was significantly higher than that in the control group (45.3％),with a statistically significant difference (x2 =12.185,P ＜ 0.01).Conclusions Iohexol can be used as a good developer spectrum of spectral CT,which may also improve the detection rate of gastric cancer.Meanwhile,corresponding nursing is also important during the process.

The epidemic of coronavirus disease 2019 (COVID-19) puts higher demands on critical care medicine. Lots of studies have been conducted to solve COVID-19-related problems. Therefore, we reviewed the annual progress for COVID-19-related issues including antivirals threapies, respiratory support and immunomodulatory therapies and other critical issues, including the effect of antibiotic on mitochondrial damage and its relationship with sepsis, the goal and direction of antimicrobial de-escalation, drug prophylaxis of constipation, bleeding in gastrointestinal disorders and management of critical illness in the informalization era and so on. We hope to provide reference for clinical and scientific research work of the intensivists.

Objective:To investigate the correlation between global burden of small vessel disease(CSVD) on MRI and impaired spatial navigation in patients with CSVD.Methods:Patients with CSVD admitted to the Department of Neurology, Nanjing Jiangning Hospital from November 2020 to June 2022 were selected as the research subjects. The global burden of CSVD was scored according to the head MRI findings, and was divided into mild group (0-1 points), moderate group (2 points), and severe group (3-4 points). All patients were tested for spatial navigation function. Multivariate linear regression model was used to analyze the correlation between the global burden of CSVD and the spatial navigation function.Results:A total of 101 patients with CSVD were enrolled, including 37 patients in the mild group (36.6%), 28 in the moderate group (27.7%), and 36 in the severe group (35.6%). Age, glycosylated hemoglobin, total cholesterol, low-density lipoprotein cholesterol and creatinine, as well as the proportions of hypertension, diabetes, previous stroke or transient ischemic attack in the moderate group and the severe group were significantly higher than those in the mild group, while the high-density lipoprotein cholesterol was significantly lower than that in the mild group (all P<0.05). The spatial navigation function test showed that the environment + self-navigation, self-navigation and environment navigation functions of the moderate group and the severe group decreased significantly compared with the mild group (all P<0.05). Multivariate linear regression analysis showed that after adjusting for age, sex, hypertension, previous stroke or transient ischemic attack history and years of education, the global burden of CSVD and environment + self-navigation ( β=0.518, P<0.001), self-navigation ( β=0.481, P<0.001) and environmental navigation ( β=0.699, P<0.001) function had significant correlation. Conclusion:The global burden of CSVD is correlated with spatial navigation functions.

Objective:To investigate the clinicopathological characteristics of gastrointestinal tumors with SWI/SNF complex deficiency and to perform a prognostic analysis of the patients.Methods:Gastrointestinal tumor cases with SWI/SNF complex deficiency expression diagnosed at the Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, China from August 2021 to May 2023 were collected. Hematoxylin and eosin (HE) stained slides were reviewed, and immunohistochemical results were analyzed. Clinical and pathological information was recorded, and relevant literature was reviewed.Results:A total of 36 cases of gastrointestinal tumor with loss of SWI/SNF complex expression were identified, including 28 males (77.8%) and 8 females (22.2%). The average age at diagnosis was 70 years (range 48-85 years). Clinical staging showed 3 cases in stage Ⅰ (8.3%), 12 cases in stage Ⅱ (33.3%), 19 cases in stage Ⅲ (52.8%), and 2 cases in stage Ⅳ (5.6%). Complete or partial loss of ARID1A expression was observed in 20 cases (55.6%); complete or partial loss of SMARCA2 expression was observed in 24 cases (66.7%). SMARCA4 exhibited complete loss of expression in 4 cases (11.1%). Eleven cases (30.6%) showed concurrent complete or partial losses of both ARID1A and SMARCA2 expression. Twelve cases (33.3%) had mismatch repair protein deficiency, all of which were characterized by MLH1/PMS2 absence. Mismatch repair protein deficiency was associated with loss of ARID1A expression ( P<0.01). Patients with mismatch repair protein deficiency were also associated with earlier clinical stage and a lower risk of lymph node metastasis compared to the ones with intact mismatch repair proteins ( P<0.05). Conclusions:SWI/SNF complex deficiency in gastrointestinal tumors is associated with dedifferentiation and often accompanied by mismatch repair protein deficiency. Compared to the cases with intact mismatch repair proteins, the cases with defective mismatch repair protein have an earlier clinical stage and a lower risk of lymph node metastasis.

【Objective】 To evaluate the quality of suspended red blood cells (SRBC) under low-pressure and hypoxic conditions, in order to lay a theoretical foundation for airline delivery, air drop and storage of SRBC on plateau. 【Methods】 The low-pressure and hypoxic conditions (0.026 MPa and 0.047 MPa) were simulated by a pressure control device. SRBC were divided into 3 groups (5 bags/group, 1.5 U/bag). Each group was stored in 0.026 MPa environment at 2℃-6℃ for 24 hours (named 0.026 MPa), in 0.047MPa environment at 2℃-6℃ for 7 days (named 0.047 MPa), and in a blood storage refrigerator at 4℃ (named the control), respectively. The storage cell characteristics were examined on day 2, 9, 14, 28 and 35. 【Results】 We found that HCT, MCV, K⁺, Na⁺, FHb, hemolytic ratio, 2, 3-DPG and rheological properties in group 0.026 MPa and 0.047 MPa were not significant different compared with that in control (P>0.05). The consumptions of Glu in group 0.026 MPa and 0.047 MPa were significantly higher (P<0.05), and a transient increase in LAC concentration of group 0.026 MPa and 0.047MPa were observed, compared to the control. 【Conclusion】 The conditions of low-pressure and hypoxia have no significant effect on the quality of suspended red blood cells.

bjective? To expLore the effects of comprehensive nursing care on adverse reactions of contrast media in enhanced CT scan. Methods? From November to December 2016, we seLected 4 413 patients with enhanced CT scan in Cancer HospitaL of Peking Union MedicaL CoLLege. ALL of the patients were divided into controL group and observation group with the random number tabLe. There were 2 010 cases in controL group with routine nursing, whiLe there were 2 403 patients in observation group with comprehensive nursing. We observed the adverse reactions and satisfaction with nursing among patients with enhanced CT scan between two groups. ResuLts? The incidence of adverse reactions of observation group was Lower than that of controL group;the patients' satisfaction with nursing of observation group was higher than that of controL group; the differences were aLL statisticaL (P＜0.05). ConcLusions? Comprehensive nursing care can reduce the incidence of adverse reactions of contrast media and improve satisfaction with nursing among patients with enhanced CT scan.