Objective To investigate the characteristics of transient remission of islet function and its influence on long-term prognosis in different onset age patients with type 1 diabetes mellitus(T1DM).Methods 156 newly diagnosed T1DM patients who received treatment and completed follow-up were retrospectively chosen from January 2014 to January 2018.All patients were grouped according to the onset age including childhood group(n=18),adolescent group(n=108),adult group(n=30).The transient remission and retention rate of islet function of three groups were compared.The relationship between onset age and c-peptide level was analyzed.Results BMI,FC-P,and 2 hC-P levels in adolescent group were higher than those in childhood group(P<0.05).The positivity rates of protein tyrosine phosphatase and zinc transporter 8 antibodies in adult group were lower than those in childhood group(P<0.05).The incidence of transient remission of pancreatic function in adolescent group was higher than that in childhood and adult groups(P<0.05).The duration of transient remission of pancreatic function in adolescent and adult groups was lower than that in childhood group(P<0.05).The islet function retention rates in adolescent group after 1 and 4 years from onset were higher than those in childhood and adult groups(P<0.05).Generalized estimation equation analysis showed that the long-term FC-P and 2 hC-P in adolescent group were higher than those in childhood and adult groups(P<0.05).The FC-P and 2 hC-P levels in adult patients with previous transient remission were higher than those in childhood group(P<0.05).Conclusions Adolescent onset T1DM patients are more likely to have transient remission of islet function,while childhood onset patients have longer transient remission of islet function.In addition,the adult T1DM patients had the best long-term islet function in transient remission population.

OBJECTIVETo observe the anesthetic efficacy and safety of bilateral ultrasound-guided supraclavicular brachial plexus block in patients undergoing arthrolysis for shoulder periarthritis.

METHODSTwenty-seven patients (ASA class I-II) undergoing bilateral shoulder joint release surgery and 24 ml received bilateral ultrasound-guided supraclavicular brachial plexus block anesthesia with 0.4% ropivacaine and 0.8% lidocaine. The visual analogue scale (VAS) scores for shoulder joint pain were recorded before and after anesthesia. The efficacy of axillary nerve, dorsal scapular nerve and suprascapular nerve block was evaluated, and the anesthetic effect and complications was assessed during surgery. Before and after anesthesia, the range of left and right diaphragmatic muscle movement was measured when the patient took a quiet breath and a deep breath.

RESULTSThe patients showed no significant variations in MAP, HR, or SpO₂after anesthesia. The VAS scores of shoulder joint pain during anteflexion, abduction, posterior extension, rotation, posterior extension and medial rotation were significantly lowered after anesthesia (P<0.05), but the left and the right diaphragm movement range showed no significant difference between quiet breath and deep breath (P>0.05). The rates of complete block of the axillary nerve and dorsal scapular nerve was 100%, and that of suprascapular nerve was 92.6%. Partial phrenic nerve block occurred in 1 case with mild local anesthetic toxicity in another.

CONCLUSIONSBilateral ultrasound-guided supraclavicular brachial plexus block in patients has excellent analgesic effect in should joint release surgery with good safely.

Amides ; Anesthetics, Local ; Brachial Plexus Block ; Diaphragm ; Humans ; Lidocaine ; Orthopedic Procedures ; Pain Measurement ; Periarthritis ; diagnostic imaging ; surgery ; Shoulder Joint ; diagnostic imaging ; physiopathology ; Ultrasonography

Objective:To compare the clinical effects of liraglutide and benaglutide in adjuvant treatment of type 2 diabetes mellitus (T2DM) patients complicated with nonalcoholic fatty liver disease (NAFLD).Methods:From January 2017 to January 2019, 110 T2DM patients complicated with NAFLD were chosen in the Fifth People's Hospital of Datong and divided into two groups according to the random digital table method, with 55 patients in each group.On the basis of metformin, the control group was given liraglutide, and the observation group was given benaglutide.The levels of BMI, waist circumference, fasting blood glucose(FPG), postprandial 2h blood glucose(2 h PG), glycosylated hemoglobin(HbA1c), fasting insulin(FINS) release level, insulin resistance index(HOMA-IR), total cholesterol(TC), triglyceride(TG), low density lipoprotein cholesterol(LDL-C), high density lipoprotein cholesterol(HDL-C), levels of glutamate aminotransferase(ALT), aminotransferase(AST), controlled attenuation parameter(CAP) and liver stiffness(LSM) before and after treatment of the two groups were compared.Results:After treatment, the levels of BMI, waist circumference, FBG, 2 h PG, HbA1c, FINS, HOMA-IR, lipid index, ALT, AST, CAP and LSM of the two groups were significantly better than those before treatment( t=3.17, 3.80; 4.95, 5.66; 3.41, 3.50; 3.85, 5.06; 4.43, 4.60; 3.55, 4.17; 3.91, 4.07; 3.26, 3.59; 4.10, 5.27; 4.01, 4.89; 3.62, 3.20; 3.97, 4.62; 4.01, 5.37; 4.66, 5.13; 4.95, 5.87; all P<0.05). After treatment, the levels of BMI, waist circumference, 2 h PG, ALT, AST, CAP and LSM of the control group were (22.01±0.98)kg/m 2, (1.63±0.38)cm, (7.04±1.71)mmol/L, (39.31±4.92)U/L, (31.40±4.94)U/L, (197.48±36.39)dB/m, (7.42±1.34)kPa, respectively, which were significantly worse than those of the observation group [(19.87±0.76)kg/m 2, (0.89±0.21)cm, (6.29±1.10)mmol/L, (36.17±3.16)U/L, (28.63±3.59)U/L, (152.77±30.18)dB/m, (6.17±1.06)kPa] ( t=2.74, 3.55, 2.81, 3.02, 2.76, 2.89, 3.15, all P<0.05). Conclusion:Compared with liraglutide, benaglutide in adjuvant treatment of T2DM patients complicated with NAFLD can efficiently decrease body weight, improve postprandial blood sugar levels, protect liver function and is helpful to inhibit liver fat deposition.