Objective To study the efficacy, safety and compliance of insulin human analog insulin aspart (NovoRapid) and insulin zinc protamine analog (Basulin) in the application on type 2 diabetes mellitus(T2DM)pafients during perioperative period. Methods Sixty T2DM patients were divided into 3 groups (n=20). Group A was treated with NovoRapid+Basulin, group B was treated with insulin human (Humulin R + Humulin N) and group C was treated with insulin pump (Humulin and NovoRapid). Blood glucose was detected in all of the patients before the meal, 2 hours after meal, before the sleep and during the operation. Results Blood glucose could all achieve the control level with the three methods of treatment. The rates of hypoglycemia in the three groups were 10%, 30% and 5% respectively, and the rates of patient satisfaction were 95%, 70% and 100% respectively. Conclusions Insulin human analog could control blood glucose effectively and safely, the compliance is also high. It is feasible of applying insulin human analog in the blood glucose control during perioperative period.

Objective To investigate the CT characteristics of primary pulmonary sarcomatoid carcinoma (PSC). Methods CT characteristics of 14 cases with primary pulmonary saromatoid cacinoma confirmed by surgical pathology were analyzed retrospectively. Results Among the 14 cases, the clinical manifestations were chest pain and cough in 6 cases, cough with blood-stained sputum in 5 cases, chest tightness and asthma in 2 cases, and no symptoms in 1 case. All the 14 cases had solitary masses in the lung. Carcinoma of 7 cases located in the upper lobe of the right lung, and carcinoma of 1 case located in the inferior lobe of the right lung. Carcinoma of 3 cases was located in the upper lobe of the left lung, and 3 cases were found in the inferior lobe of the left lung. Eleven cases had peripheral tumors and 3 cases had central tumors. CT plain scan revealed an isodense mass. There were 12 cases with uneven mass density and necrosis, and 2 cases had uniform mass density. The smooth margin was identified in 7 masses, and ill-defined margin and lobulation was shown in 7 masses. Cavity was observed in 1 mass, and speckled calcification was seen in 1 mass. Pleural invasion and thickening was in 5 cases, pneumothorax occurred in 1 case, and there was 1 case of liver metastasis. Enhancement scan showed patchy or annular enhancement around the mass, and the central enhancement of the mass was not obvious or uneven patchy enhancement. Conclusions The CT characteristics of primary pulmonary sarcomatoid carcinoma are solitary masses in the lung, especially if the mass is located in the periphery of the upper lobe of the right lung with uneven density, and enhancement scan shows patchy or annular enhancement around the mass.

Objective:To investigate the CT and MRI features of meningiomas of the skull.Methods:A retrospective analysis was performed; the CT and MRI findings of 20 patients with meningiomas of the skull confirmed by pathology after surgery in our hospital from January 2008 to December 2020 were collected.Results:Fourteen patients had skull osteolytic destruction, 4 had osteogenic destruction, and 2 had mixed destruction. There were 12 patients with soft tissue masses and 11 with radial spicules. In 16 patients accepted CT examination, uniform density was noted in 10 and uneven density in 6; 8 had high density, 5 had equal density, and 3 had low density; 5 patients were with calcification. In 17 patients accepted MRI examination, 11 had uniform signal and 6 had un-uniform signal; T1WI had slightly low signal in 12 patients and equal signal in 5 patients; T2WI had slightly high signal in 12 patients and slightly low signal in 5 patients; diffusion weighted imaging (DWI) had high signal in 12 patients and slightly high signal in 5 patients. Totally, enhanced homogeneous enhancement was noted in 12 patients and inhomogeneous enhancement was noted in 8 patients; and there were 13 patients with "meningeal tail sign" and 11 with peritumoral edema.Conclusion:Bone in patients with meningiomas of the skull is characterized by osteolytic or osteogenic destruction with soft tissue masses and radial spicules; CT shows uniform or un-uniform tumor density, MRI shows uniform or un-uniform signals, and enhanced "meningeal tail sign" is characterized.

Objective:To analyze the effect of the over-the-scope-clip system (OTSC) system in the treatment of iatrogenic gastrointestinal perforation.Methods:Retrospective selection of clinical data from 21 patients with gastrointestinal perforation during endoscopic examination and treatment from May 2016 to December 2023 in the Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University. By analyzing the patient's basic information, perforation cause, perforation diameter, length of hospital stay, post-treatment outcome, complications, and treatment success rate, the effectiveness of using the OTSC system to treat iatrogenic gastrointestinal perforation is comprehensively evaluated, and the influencing factors that may be related to the failure of OTSC system closure are analyzed. Independent sample t-test is used for inter group comparison of metric data that conforms to normal distribution. Fisher's exact probability test was used for inter group comparison of count data.Results:There were 21 cases of acute iatrogenic gastrointestinal perforation, including 12 males and 9 females, aged (61.95±15.47) years, 4 cases of duodenal perforation, 10 cases of gastric perforation, and 7 cases of colon perforation. The diameter of the perforation was (1.18±0.56)cm, and the perforation sealing time was (8.29±4.42) min. Among the 21 patients, 5 cases of occlusion failed, of which 2 cases of sigmoid colon perforation were transferred to surgery in time due to OTSC insufficiency, 3 cases were perforated in duodenal colon and colonic splenic area, 3 cases of delayed abdominal infection after OTSC system occlusion, 16 cases of OTSC system closure and perforation without complications such as delayed perforation, and the average length of hospital stay of patients in the OTSC system wound closure group was (11.56±6.53) d, which was shorter than that in the OTSC system closure failure group ((38.00±21.34) d), The proportion of passive perforation in the failure group (100%, 5/5) > the success group (31%, 5/16).The occlusion success rate of passive perforation in the OTSC system (50%, 5/10) < active perforation (100%, 11/11), the diameter of perforation of the failure group ((1.72±0.80)cm) was significantly > that of the successful group ((1.06±0.49)cm), the diameter of perforation ≥2.0 cm in the failure group (80.0%, 4/5) was significantly > that of the successful group (12.5%, 2/16), the proportion of duodeno-colonic perforation in the failure group (100.0%, 5/5) > the success group (37.5%, 6/16), the difference was statistically significant ( P values were 0.049, 0.012, 0.012, 0.037, 0.011, and 0.035, respectively). Conclusion:The closure of acute iatrogenic gastrointestinal perforation by the OTSC system has significant therapeutic effects and can reduce the probability of surgical conversion due to perforation to a certain extent. It is worth promoting and applying. The diameter of the perforation (≥2 cm), the perforation method (passive perforation), and the perforation site (the difficult part of duodenum-colon operation) may be the relevant influencing factors for the failure of the occlusion of the OTSC system.

Objective:To investigate the characteristics of computed tomography(CT) and magnetic resonance imaging(MRI)of focal peliosis hepatis (PH).Methods:From January 1, 2015 to December 31, 2022, a total of 8 PH patients (10 lesions) diagnosed pathologically in Yueqing People′s Hospital were collected. The location, size, and shape of the lesions, as well as the CT (4 patients with 4 lesions) and MRI (5 patients with 7 lesions) characteristics of the patients were analyzed. Descriptive method was used for statistical analysis.Results:Among the 8 PH patients, 6 patients had lesions located in the right lobe of the liver, 1 in the left lobe of the liver, and 1 (3 lesions) in both left and right lobes of the liver. Eight lesions were round or round-like, and 2 lesions were irregularly shaped. The median maximum diameter of the lesions was 4.2 cm (ranged from 2.2 to 9.3 cm), of which the maximum diameters of 2 lesions were less than 3.0 cm, those of 6 lesions were 3.1 to 5.0 cm, and those of 2 lesions were more than 6.0 cm. Nine lesions had clear boundaries, and 1 lesion had blurred boundary; 9 lesions had capsule, 1 lesion had no capsule; 1 lesion had blood vessels passing through it. The CT plain scan of 4 patients (4 lesions) showed that 3 lesions had uniform density and 3 lesions had low density, the CT enhancement showed that 2 lesions were significantly enhanced in the arterial phase, 3 lesions were sustained moderately enhanced in the portal phase, and 2 lesions were sustained mildly enhanced in the delayed phase. The MRI plain scan of 5 patients (7 lesions) showed uniform signals in 6 lesions, low signal in 3 lesions and equal signal in 4 lesions on T1-weighted images, high signal in 6 lesions on T2-weighted images, high signal in 3 lesions and equal signal in 4 lesions on diffusion-weighted images. The MRI enhancement showed that 4 lesions were significantly enhanced in the arterial phase, 5 lesions were sustained moderately enhanced in the portal phase, and 6 lesions showed sustained mild enhanced in the delayed phase.Conclusion:The PH lesions are round or round-like, with clear or unclear boundaries and uniform or uneven density, and are characterised by low density on CT and MRI plain scan, low signal on T1-weighted images, and high signal on T2-weighted images and diffusion-weighted images, and moderate or significant sustained enhancement on CT and MRI enhancement.

Objective:To analyze the relationship and clinical value between serum matrix metalloproteinases-3 (MMP-3) and rheumatoid arthritis (RA).Methods:By using retrospective study to collect 123 patients with RA diagnosed in our hospital from January 2019 to January 2020 as the RA group. Among the patients, there are 25 males and 98 females, the median age is 60 years old. During the same term, 53 healthy people were selected as the control group, with 12 males and 41 females, the median age is 55 years old. MMP-3, erythrocyte sedimentation rate (ESR), high sensitivity C-reactive protein (hs-CRP), rheumatoid facotrs (RF), anti-cyclocitrulline factor (ACCP) in peripheral blood of all subjects were detected. Disease activity score of 28 joints (DAS28) were collected. This research used T test, Spearman correlation analysis and receiver operating characteristic curve (ROC curve) to analyze the relationship between MMP-3 and other clinical biochemical indices, and the efficacy of MMP-3 in the diagnosis of RA.Results:Compared with the control group (26.30±14.83)ng/ml, the levels of serum MMP-3 in the RA group (79.71±123.54) ng/ml had significantly increased ( t=-4.95, P<0.001). The serum concentration of MMP-3 in RA patients was significantly correlated with ESR, hs-CRP and DAS28 ( r value were 0.521, 0.372, 0.405 respectively, P<0.001). The area under the curve (AUC) of MMP-3 to diagnose RA was 0.765, and the sensitivity was 64.44%, and the specificity was 75.76%, cut-off of MMP-3 were 32.50 ng/ml. Conclusions:The levels of serum MMP-3 in the RA group had significantly increased. MMP-3 and the disease activity were highly correlated. MMP-3 can be used as an indicator of RA disease activity, also can significantly improve the diagnostic efficacy, treatment and warning of early RA.