Objective To investigate the effects of Dapagliflozin combined with insulin treatment on blood glucose index and pancreatic β-cell function in overweight/obese type 2 diabetes mellitus(T2DM) patients with different disease durations. Methods A total of 288 patients with impaired pancreatic function who were treated from June 2019 to June 2020 were selected. They were divided into three groups,short duration group (≤10 years group,n=95),medium duration group (10～20 years group,n=96) and long duration group (≥20 years group,n=97). Three groups of patients were treated with Dapagliflozin in addition to the regular insulin therapy for 6 months. Clinical efficacy,blood glucose indices,pancreatic β-cell function and complications during the treatment period were compared among the three groups. Results After treatment,there was a significant decrease in the values of three groups including WC,FPG,2 hPG,HbA1c,TC,TG,LDL-C,BMI,FIns and HOMA-IR(P<0.05). Meanwhile,HDL-C,C-P,HOMA-β and HOMA-IS values showed a significant increase(P<0.05). After treatment,WC,FPG,2 hPG,HbA1c,TC,TG,LDL-C,FIns and HOMA-IR increased in turn(P<0.05),while HDL-C,C-P,HOMA-β and HOMA-IS decreased in turn in ≤10 years group,10～20 years group,≥20 years group(P<0.05). The BMI of 10～20 years group was lower than that of ≤10 years group and ≥20 years group (P<0.05),while the BMI of ≥20 years group was higher than that of ≤10 years group (P<0.05). Conclusions In overweight/obese T2DM patients with different DM durations,Dapagliflozin combined with insulin treatment shows a significant advantage in lowering blood glucose indices and improving pancreatic β-cell function,especially for patients with a shorter disease duration.

Objective To investigate the effects of Dapagliflozin combined with insulin treatment on blood glucose index and pancreatic β-cell function in overweight/obese type 2 diabetes mellitus(T2DM) patients with different disease durations. Methods A total of 288 patients with impaired pancreatic function who were treated from June 2019 to June 2020 were selected. They were divided into three groups,short duration group (≤10 years group,n=95),medium duration group (10～20 years group,n=96) and long duration group (≥20 years group,n=97). Three groups of patients were treated with Dapagliflozin in addition to the regular insulin therapy for 6 months. Clinical efficacy,blood glucose indices,pancreatic β-cell function and complications during the treatment period were compared among the three groups. Results After treatment,there was a significant decrease in the values of three groups including WC,FPG,2 hPG,HbA1c,TC,TG,LDL-C,BMI,FIns and HOMA-IR(P<0.05). Meanwhile,HDL-C,C-P,HOMA-β and HOMA-IS values showed a significant increase(P<0.05). After treatment,WC,FPG,2 hPG,HbA1c,TC,TG,LDL-C,FIns and HOMA-IR increased in turn(P<0.05),while HDL-C,C-P,HOMA-β and HOMA-IS decreased in turn in ≤10 years group,10～20 years group,≥20 years group(P<0.05). The BMI of 10～20 years group was lower than that of ≤10 years group and ≥20 years group (P<0.05),while the BMI of ≥20 years group was higher than that of ≤10 years group (P<0.05). Conclusions In overweight/obese T2DM patients with different DM durations,Dapagliflozin combined with insulin treatment shows a significant advantage in lowering blood glucose indices and improving pancreatic β-cell function,especially for patients with a shorter disease duration.

Abstract]? Objective? To establish an emergency-nursing pathway for acute ischemic stroke interventional thrombectomy and to evaluate its effects. Methods? Through convenient sampling, a total of 117 patients admitted to the Yantaishan Hospital from June 2017 to June 2018 with acute ischemic stroke and treated with interventional thrombectomy were selected as research subjects. According to the random number table method, it was divided into 60 cases in the control group and 57 cases in the experimental group. The routine surgical supportive nursing plan was used in the control group and the new emergency-nursing pathway were used in the experimental group. The door-to-puncture time (DPT), and the cooperation quality in the surgical team were selected as evaluation indexes. Results? The time of opening the package, the establishment of venous access, the preparation of emergency equipment, the preparation of emergency medicine, and the oxygen inhalation time of the experimental group were all less than the control group. The difference between the two groups was statistically significant (P＜0.05). The consumables appeared in the operation group. The number of times the medicine or equipment was used incorrectly or misused was lower than that of the control group. Conclusions? The establishment of emergency-nursing pathway saved the time for the thrombectomy, and promoted the cooperation of the surgical team.

OBJECTIVE:To observe the effects of epalrestat combined with lipoic acid on nerve function,oxidative stress and inflammatory reaction in patients with diabetic peripheral neuropathy(DPN). METHODS:From Jan. 2013 to Jan. 2016,150 pa-tients were selected from our hospital and then divided into group A,B,C according to random number table,with 50 cases in each group. Group A was given Lipoic acid injection 600 mg,ivgtt,qd;group B was given Epalrestat tablet 50 mg,po,tid;group C was given lipoic acid+epalrestat,same usage and dosage as above. TSS score,MNCV,SNCV,oxidative stress indexes (SOD and MDA)and inflammatory indexes(TNF-α and IL-6),as well as blood pressure,blood lipid and blood glucose indexes were compared among 3 groups before and after treatment. The occurrence of ADR were observed. RESULTS:Before treatment, there was no statistical significance in above indexes among 3 groups (P>0.05). Compared to before treatment,TSS score, MDA,TNF-α and IL-6 levels of 3 groups were decreased significantly after treatment;MNCV and SNCV were speeded up signifi-cantly,and SOD level was increased significantly;each index of group C was better than that of group A and B,with statistical significance(P<0.05),but there was no statistical significance between group A and B(P>0.05). SBP and FPG after treatment of 3 groups were decreased significantly than before treatment,while HDL-C was increased significantly,with statistical signifi-cance(P<0.05);there was no statistical significance among 3 groups(P>0.05). No obvious ADR was found in 3 groups. CON-CLUSIONS:Epalrestat combined with lipoic acid can effectively improve nerve function in DPN patients by inhibiting oxidant stress and inflammatory reaction with good safety. The effect of drug combination is better than single drug.

Objective To study the effect of the combination of pathidine hydrochloride and anisodamine on the intraoperative effiacy of transhepatic biliary drainage and stent implantation done on the patient with advanced malignant obstructive jaundice.Methods 100 cases of percutaneous transhepatic catheterizde drainage (PTCD) and percutaneous transhepatic biliary stenting (PTBS) done for advanced malignant obstructive jaundice were divided into control group and experimental group,50 cases in each group.In experimental group,100 mg pethidine hydrochloride and 10 mg anisodamine were injected intramuscularly 30 min before operation,while in control group,no analgesic or antispasmodic were used before and during operation.The blood pressure and heart rate were observed,the incidence rate of biliary-cardiac reflex and operating time were recorded,while the scale of pain felt by patient was evaluated with visual analogue scale.Results Compared to the control group,the patients in experimental group have more stable vital signs,feel more comfortable,suffering shorter operative time,less incidence rate of biliary cardiac reflex and less pain by using pethidine hydrochloride and anisodamine.Conclusion Application of pathidine hydrochloride and anisodamine during the transhepatic biliary drainage and stent implantation done on the patient with advanced malignant obstructive jaundice may release pain,reduce operating time.It is safe,at lower cost and can be used as routine medicine before PTCD or PTBS.

Objective To analyze CT and MRI manifestations of the aneurysmal bone cyst and to evaluate the value of its imaging diagnosis.Methods The manifestations of CT and MRI of the aneurysmal bone cyst confirmed by operation or puncture were analysed retrospectively.Results On CT images,there were obvious liqued-liqued level within the lesions in 16 cases,in which,the CT values in up part was lower than that in low part,and there were obvious soft tissue mass in secondary aneurysmal bone cyst.While,on MRI,all lesions appeared obvious liqued-liqued level except one secondary example,and the soft tissue mass of secondary aneurysmal bone cyst was clear showed.Conclusion Most of aneurysmal bone cyst appear liqued-liqued level within the lesions on CT and MRI,it is a characteristic sign,but not the only one.