Glucagon-Like Peptide 1 ; Humans ; Non-alcoholic Fatty Liver Disease

Objective To evaluate the clinical value of ultrasonography guided percutaneous core needle biopsy in pancreatic lesions. Methods Thirty-four patients with 36 pancreatic lesions in Shanghai First People′s Hospital Afifliated to Shanghai Jiao Tong University from February 2012 to November 2013 underwent conventional ultrasound-guided percutaneous core needle biopsy using automatic gun and 18-gauge biopsy needles. The site, size, internal and surrounding vascularity, the sampling number of the lesions, and whether the specimens′ quality was satisfied were recorded. Then specimens were sent for pathological examination, and all above observations were compared with the ifnal diagnosis. Results The number of lesions with 2, 3 and 4 samplings was 32, 2 and 2, respectively. The average number of sampling was 2.2 (mean, 2.17;standard deviation, 0.51) and the acquisition rate of satisifed specimens was 89%(32/36). The pathological results of biopsy were malignant in 31 of 36 lesions including 27 cases of ductal adenocarcinoma, 2 cases of lymphoma, 1 case of small cell neuroendocrine carcinoma and 1 case of uterine leiomyosarcoma metastasis. The other 5 lesions were non-malignant including 3 cases of benign lesion, 1 cases of atypical hyperplasia and 1 cases of granulation tissue. The 36 lesions were ifnally diagnosed as 34 cases of pancreatic malignancy, 2 cases of non-malignant neoplasm. The sensitivity, speciifcity, accuracy, positive predictive value and negative predictive value of ultrasonography guided percutaneous core needle biopsy in pancreatic lesions were 91%(31/34), 100%(2/2), 92%(33/36), 100%(31/31) and 40%(2/5), respectively. Youden index was 0.91. Two patients had mild upper abdominal pain and 1 patient had transient elevated serum amylase. No pancreatitis, pancreatic fistula, peritonitis, bleeding or dispersion of malignant cells along the penetrating channel or other serious complications occurred. Conclusion Ultrasonography guided percutaneous core needle biopsy is a simple, rapid, safe and effective diagnostic method in pancreatic lesions with high clinical value.

Emergency transport of critically ill neonates is an important means to reduce neonatal mortality and improve prognosis.Neonatal transport score is used to evaluate the safety of transport, mainly including transport risk index of physiologic stability, mortality index for neonatal transportation, transport related mortality score and intrauterine transport score.Evaluating the severity of disease of critically ill newborns before, during and after transport can reduce the occurrence of transport complications, reduce neonatal mortality, improve prognosis and increase the success rate of treatment.This paper reviews the research progress of critical neonatal transport scoring at home and abroad to help clinicians choose appropriate scoring methods according to specific conditions, in order to provide a basis for continuous quality improvement in this field.

The "golden hour" strategy is an important measure to improve the short-term and long-term prognosis of neonates.It refers to optimizing interventions within one hour after birth, including neonatal resuscitation, transportation and early active treatment measures.Preterm birth and its complications are one of the main causes of neonatal death.Studies about "golden hour" strategy in premature infants have confirmed that it can increase the early stability, reduce complications and improve prognosis of preterm infants.This article reviews recent progress of "golden hour" in preterm infants and provide more information about quality improvement in premature infants care.

Objective:To develop a fully automatic detection system based on the deep convolution neural network (DCNN) for screening myopic maculopathy (MMD) and identifying its severity.Methods:Six thousand and sixty-eight fundus images were collected from Anhui No.2 Provincial People's Hospital to construct the training set, and the public fundus images data set was selected to construct the test set.The fundus images were preprocessed and amplified, and the grade of MMD lesions was labeled and the data was cleaned.The automatic MMD detection system proposed was composed of two-level network.The first level network structure was used to identify the presence of MMD, and the second level network structure was used to diagnose the severity of MMD lesions.The accuracy, specificity, sensitivity, precision, F1 value, area under curve (AUC) and Kappa coefficient of four commonly used DCNN network methods, VGG-16, ResNet50, Inception-V3 and Densenet, in MMD screening and severity recognition tasks were compared and analyzed.The study protocol adhered to the Declaration of Helsinki and was approved by a Medical Ethics Committee of Anhui No.2 Provincial People's Hospital ([L]2019-013).Results:The performance of Densenet network model was the best in the MMD screening task, with the sensitivity, specificity, accuracy, F1 value and AUC of 0.898, 0.918, 0.919, 0.908 and 0.962, respectively.The Inception-v3 network model was the best in MMD severity recognition task, with sensitivity, specificity, accuracy, F1 value and AUC of 0.839, 0.952, 0.952, 0.892, and 0.965, respectively.The visualization results showed that the network structure model used in this study could automatically learn the clinical characteristics of MMD severity, and accurately identify diffuse and focal chorioretinal atrophy areas.Conclusions:The MMD screening method using fundus images based on DCNN can automatically extract the effective features of MMD, and accurately screen MMD and judge its severity, which can provide effective assistance in clinical practice.

Objective:To investigate the adhesion of polydopamine-modified collagen membrane composites to cartilage tissues and the effect on chondrocyte proliferation, and further explore the possibility of their application in autologous chondrocyte transplantation.Methods:Porous collagen membranes were prepared, and the polydopamine-modified collagen membrane composites were constructed by the adsorption method. The physical and chemical properties and structural characteristics of the membranes, such as thermal stability, thermal properties, porous structure, and surface element composition, were characterized by infrared spectroscopy, thermogravimetric analysis, differential thermal analysis, scanning electron microscopy, and X-ray photoelectron spectroscopy, respectively. The adhesion between the polydopamine-modified collagen membrane and fresh cartilage tissue was tested by a mechanical testing machine. The effects of the membranes on the adhesion and proliferation of rabbit chondrocytes were investigated by in vitro cell culture.Results:The structure and surface element composition of the membranes altered with the increase in the adsorption time of polydopamine, and the capacity of polydopamine increased with the increase in the adsorption time. The thermal stability and thermal properties of collagen membrane materials were not significantly affected by the adsorption of polydopamine. The adhesion of the membrane to cartilage tissue increased with the increase in the amount of absorbed polydopamine. The membranes showed a time-dependent promoting effect on the proliferation of the chondrocytes.Conclusions:The polydopamine-modified collagen membrane has potential application in articular cartilage repair, but more research is required to optimize the membrane before it is used in articular cartilage repair.

This is a follow-up study in two patients who were diagnosed with the occult ectopic adrenocorticotropin syndrome ( EAS) and treated with mifepristone in our hospital. The efficacy and adverse reactions of mifepristone in these two patients with EAS were investigated. The patients had significant improvement in clinical manifestations, the plasma adrenocorticotropic hormone ( ACTH) and cortisol levels decreased in patient 1, while patient 2 remained stable during the treatment. Patient 1 with diabetes mellitus stopped hypoglycemic agents, while the dose of antihypertensive drugs decreased in patient 2 with hypertension, and she was treated with surgery and suffered from transient adrenocortical insufficiency after surgical excision of the lesion. Mifepristone is effective and safe in treating EAS. Surgical treatment should be performed once the lesion is found during the follow-up.

Restless legs syndrome (RLS) and ischemic cerebrovascular disease (ICVD) are two common disorders in neurology departments that place a significant economic burden on patients′ families and society. In recent years, increasing attention has been paid to the relationship between the two, but there is no clear-cut conclusion that RLS may be both a consequence of ICVD and associated with an increased risk of developing ICVD and poor functional outcome. This article summarizes the latest research findings on ICVD and RLS in China and abroad, with a view to providing a better understanding of their interaction and pathophysiological mechanisms, as well as providing some references for the early prevention and treatment of ischemic cerebrovascular events and rehabilitation.

Objective: To explore the relationship between cardiorespiratory fitness and executive function in Chinese adolescents, so as to provide a reference for promoting the overall development of Chinese adolescents physical and mental health. Methods: From September to December 2022, a total of 5 018 adolescents aged 13 to 18 years from Shanghai, Suzhou, Taiyuan, Wuyuan, Xingyi, and Urumqi were selected by stratified cluster sampling method to assess cardiorespiratory fitness and executive function. Pearson s correlation and linear hierarchical regression were performed to analyze the relationship between cardiorespiratory fitness and executive functions. Results: Among the sample of adolescents, maximal oxygen consumption (VO 2max ) was negatively correlated with the refreshing(1-back, 2-back) and conversion executive function responses ( r=-0.07, -0.12, -0.12, P <0.01). Linear regression analysis showed that VO 2max was negatively correlated with the reaction times of the refreshing(1-back, 2-back) and conversion functions ( B=-2.99, -6.44, -1.69, P <0.01). Conclusions Higher cardiorespiratory fitness among adolescents is associated with better performance in executive function. Teenagers should strengthen high intensity cardiopulmonary endurance exercise to promote the improvement of executive function.

Objective To explore the effect of head acupuncturing therapy combined with massaging key head acupoints on language and cognitive function in children with autism.Methods 60 children with autism who visited the Department of Pediatric Rehabilitation of our hospital from January 2021 to June 2022 were selected as subjects,who were then randomly divided into the conventional group treated with the conventional rehabilitation training and the combination group treated with head acupuncturing therapy combined with massaging the key acu-points,apart from conventional rehabilitation training 30 cases in each group.The cognitive function,developmental status,and parental quality of life before and after the treatment were compared between the two groups,and so were the language function and safety.Results There were no significant differences in the scores by Autism Behavior Checklist(ABC)and Childhood Autism Rating Scale(CARS),adaptability scores,language scores,and individual-social interaction scores between the conventional group and the combination group before the treatment(P>0.05).After the treatment,the scores by ABC and CARS were significantly decreased in both groups,and the scores of the combination group were significantly lower than those in the conventional group(P<0.05);The adaptability scores,language,individual-social interaction scores were significantly increased in both groups,and the scores of the combined group were significantly higher than those of the conventional group(P<0.05).The abnormal rates of symbolic expression,language comprehension,action-oriented subjects,and language development delay in the combined group were all significantly lower than those in the conventional group(P<0.05).There was no significant difference in the scores by the QL-Index between the conventional group and the combined group before the treatment(P>0.05),but after the treatment,the QL-Index scores of the conventional group and the combination group were increased,and the score of the combination group was significantly higher than that of the conventional group(P<0.05).The results of blood routine,urine routine,stool routine,liver function,and kidney function in both groups were not significantly abnormal.There was one case of mild swelling and pain at the acupunctured site in the combination group,which was improved without intervention.Conclusion Head acupuncturing therapy combined with massaging the key head acupoints can improve language function,cognitive function,and development of autis-tic children.In addition,it can enhance parental quality of life and have a high level of safety.