Objective To study the relationship between interleukin-6(IL-6) and the newly diagnosed type 2 diabetes mellitus with Dampness-Heat Encumbering the Spleen syndrome and the relationship between overweight and IL-6. Methods The plasma levels of IL-6 were detected by radio immunoassay in 40 patients with the newly diagnosed type 2 diabetes mellitus (Dampness-Heat Encumbering the Spleen syndrome 10 cases and the deficiency of Qi and Yin syndrome 10 cases)and 10 healthy adults. The changes of body mass index (BMI) and waist-hip ratio (WHR) were observed and analyzed in each group. Results The level of IL-6 in blood plasma of patients with the newly diagnosed type 2 diabetes mellitus were obviously higher than that in normal group (P< 0.01); IL-6 level in patients with Dampness-Heat Encumbering the Spleen syndrome and overweight were obviously higher than those with the deficiency of Qi and Yin syndrome (P< 0.01). Conclusion Interaction between the high level of cytokines and (or) overweight may affect the normal immune function, and promote the development of diabetes, especially in patients with Dampness-Heat Encumbering the Spleen syndrome. The high level of IL-6 may indicate the large possibility of future T2DM and can be considered as a new diagnosis of T2DM syndrome differentiation.

Objective To study the feasibility of laparoscopic cholecystectomy(LC)combined with laparoscopic appendectomy(LA).Methods One hundred and thirty patients of cholecystitis with acute appendicitis or chronic appendicitis were treated by LC combined with LA at the same operation.Results One hundred and tweent-nine cases were operated successfully.1 case was converted to open operation .No complications occurred in this series.Conclusions LC combined with LA in treating patients with cholesystitis combined with acute appendicitis or chronic appendicitis is a preferable method.

To compare the early-phase secretion between islet α cells and β cells in subjects with normal glucose tolerance and to explore the influencing genetic factors on the function of islet cells.40 subjects with normal glucose tolerance and family history of diabetes ( FH+ ) and 55 healthy volunteers without family diabetes history ( FH ) were collected.Fasting and L-arginine stimulating insulin,glucagon,and tasting free fatty acid,as well as other indicators were determined in all subjects.Insulin resistance was evaluated by homeostasis model assessment for insulin resistance.After adjnsting for sex,age,and body mass index,the insulin secretion peak of the two groups reached both at two min,and began to decline at four min,the peak multiple of FH+group was significantly less than that of FH-group (7.29 vs 8.88,P＜0.05) ; glucagon secretion peak of both groups reached at two min and began to decline by four min.Fasting glucagon and peak multiple were not significantly different (P＞0.05) ; The ratio of fasting insulin to fasting glucagon of the two groups was without significantly difference ( P＞0.05 ).Under diabetes genetic background,the function of β cells decreases even in subjects with normal glucose tolerance.

Objective:To discuss the effect of pharmacist intervention on the use of antimicrobial agents in the clinical pathway of community-acquired pneumonia ( CAP) in our hospital to standardize the rational medication and promote the rational use of antimicro-bial agents. Methods:Totally 100 bacterial CAP patients in 2013 ( before the intervention) and 2014 ( after the intervention) in the pneumology department were studied. The antibacterial drug cost, total hospitalization cost, use intensity of antimicrobial drugs, hospi-talization time, therapeutic effects and so on in the two groups were observed during the treatment. Results: There were significant differences between the two groups in antibacterial drug cost, total hospitalization cost, use intensity of antimicrobial drugs, hospitaliza-tion time and so on, whereas there was no significant difference in the curative effect. Conclusion:After the pharmacist intervention, the application of antibiotics is more rational, the antibiotics use density and per capita cost are reduced, the hospitalization day is shortened and the value of pharmacists is also improved.

Objective:To establish a predictive model for the progression of acute kidney injury (AKI) to stage 3 AKI (renal failure) in the intensive care unit (ICU), so as to assist physicians to make early and timely decisions on whether to intervene in advance.Methods:A retrospective analysis was conducted. Thirty-eight patients with AKI admitted to the intensive care medicine of the Third People's Hospital of Henan Province from January 2018 to May 2023 were enrolled. Patient data including acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) upon admission, serum creatinine (SCr), blood urea nitrogen (BUN), daily urine output during hospitalization, and the timing of continuous renal replacement therapy (CRRT) intervention were recorded. Based on clinically collected pathological data, standardized creatinine value ratio mean polynomial fitting models were established as the first criterion for judging the progression to stage 3 AKI after data cleansing, screening, and normalization. Additionally, standardized creatinine value ratio index fitting models were established as the second criterion for predicting progression to stage 3 AKI.Results:A total of 38 AKI patients were included, including 25 males and 13 females. The average age was (58.45±12.94) years old. The APACHEⅡ score was 24.13±4.17 at admission. The intervention node was (4.42±0.95) days. Using a dual regression model approach, statistical modeling was performed with a relatively small sample size of statistical data samples, yielding a scatter index non-linear regression model for standardized creatinine value ratio data relative to day " n", with y = 1.246?2 x1.164?9 and an R2 of 0.860?1, indicating reasonable statistical fitting. Additionally, a quadratic non-linear regression model was obtained for the mean standardized creatinine value ratio relative to day " n", with y = -0.260?6 x2+3.010?7 x-1.612 and an R2 of 0.998?9, indicating an excellent statistical fit. For example, using a baseline SCr value of 66 μmol/L for a healthy individual, the dual regression model predicted that the patient would progress to stage 3 AKI within 3-5 days. This prediction was consistent when applied to other early intervention renal injury patients. Conclusion:The established model effectively predicts the time interval of the progression of AKI to stage 3 AKI (renal failure), which assist intensive care physicians to intervene AKI as early as possible to prevent disease progression.