Objective:To compare the efficacy and safety of insulin degludec and insulin glargine U100 in patients with type 2 diabetes mellitus.Methods:This study was a retrospective cohort study. The subjects were patients with type 2 diabetes mellitus who were hospitalized in 13 3A-level general hospitals in Shandong Province from September 2018 to December 2021. According to the type of basal insulin used, the patients were divided into insulin degludec group and insulin glargine U100 group. The basic information and laboratory test results in patients in the 2 groups were collected, the differences of fasting blood glucose level and incidence of hypoglycemia between the 2 groups were compared. The patients with complete blood glucose monitoring data in the 2 groups were selected and their blood glucose fluctuations were compared.Results:A total of 1 152 patients were entered in the study, including 552 patients in the insulin degludec group and 600 patients in the insulin glargine U100 group. The difference in the basic conditions in patients in the 2 groups was not statistically significant (all P>0.05). After treatment, the fasting blood glucose levels in patients in the 2 groups were lower than those before treatment, with statistically significant differences [10.2 (8.8, 12.5) mmol/L vs. 7.5 (6.6, 8.7) mmol/L, Z=-19.443, P<0.001; 10.0 (8.6, 11.7) mmol/L vs. 7.8 (6.6, 9.0) mmol/L, Z=-15.449, P<0.001], but the difference in fasting blood glucose levels between the 2 groups after treatment was not statistically significant ( Z=-1.427, P>0.05). The incidence of hypoglycemia in the insulin degludec group was lower than that in the insulin glargine U100 group [1.09% (6/552) vs. 2.83% (17/600), Z=4.481, P=0.032]. The intraday blood glucose standard deviation, maximum blood glucose fluctuation range, postprandial blood glucose fluctuation range, and average blood glucose fluctuation range in patients with complete blood glucose monitoring data in the insulin degludec group were significantly lower than those in the insulin glargine U100 group [(1.7±0.6) mmol/L vs. (2.4±1.0) mmol/L, (4.5±1.6) mmol/L vs. (6.7±2.9) mmol/L, (1.8±1.0) mmol/L vs. (3.3±1.2) mmol/L, (2.9±1.3) mmol/L vs. (4.6±2.1) mmol/L; all P<0.001]. Conclusion:The efficacy of insulin degludec in the treatment of type 2 diabetes mellitus is equivalent to that of insulin glargine U100, but the risk of hypoglycemia and blood glucose fluctuation is lower.

Objective:To compare the efficacy and safety of insulin degludec and insulin glargine U100 in patients with type 2 diabetes mellitus.Methods:This study was a retrospective cohort study. The subjects were patients with type 2 diabetes mellitus who were hospitalized in 13 3A-level general hospitals in Shandong Province from September 2018 to December 2021. According to the type of basal insulin used, the patients were divided into insulin degludec group and insulin glargine U100 group. The basic information and laboratory test results in patients in the 2 groups were collected, the differences of fasting blood glucose level and incidence of hypoglycemia between the 2 groups were compared. The patients with complete blood glucose monitoring data in the 2 groups were selected and their blood glucose fluctuations were compared.Results:A total of 1 152 patients were entered in the study, including 552 patients in the insulin degludec group and 600 patients in the insulin glargine U100 group. The difference in the basic conditions in patients in the 2 groups was not statistically significant (all P>0.05). After treatment, the fasting blood glucose levels in patients in the 2 groups were lower than those before treatment, with statistically significant differences [10.2 (8.8, 12.5) mmol/L vs. 7.5 (6.6, 8.7) mmol/L, Z=-19.443, P<0.001; 10.0 (8.6, 11.7) mmol/L vs. 7.8 (6.6, 9.0) mmol/L, Z=-15.449, P<0.001], but the difference in fasting blood glucose levels between the 2 groups after treatment was not statistically significant ( Z=-1.427, P>0.05). The incidence of hypoglycemia in the insulin degludec group was lower than that in the insulin glargine U100 group [1.09% (6/552) vs. 2.83% (17/600), Z=4.481, P=0.032]. The intraday blood glucose standard deviation, maximum blood glucose fluctuation range, postprandial blood glucose fluctuation range, and average blood glucose fluctuation range in patients with complete blood glucose monitoring data in the insulin degludec group were significantly lower than those in the insulin glargine U100 group [(1.7±0.6) mmol/L vs. (2.4±1.0) mmol/L, (4.5±1.6) mmol/L vs. (6.7±2.9) mmol/L, (1.8±1.0) mmol/L vs. (3.3±1.2) mmol/L, (2.9±1.3) mmol/L vs. (4.6±2.1) mmol/L; all P<0.001]. Conclusion:The efficacy of insulin degludec in the treatment of type 2 diabetes mellitus is equivalent to that of insulin glargine U100, but the risk of hypoglycemia and blood glucose fluctuation is lower.

Objective To study the CT perfusion imaging features of pancreas under liver cirrhosis.Methods 191 cases including 48 normal controls(group A)and 143 patients with liver cirrhosis(group B)were randomly collected according to the inclusion and exclusion criteria.The scope of pancreatic perfusion imaging scan was determined based on conventional plain CT scan of middle and upper abdomen.All patients were injected with contrast agent at the antecubital vein tunnel group and then with normal saline at the same rate.The original perfusion images were transmitted to the workstation and were analyzed by the pancreatic perfusion software package,and the perfusion parameters were recorded for statistical analysis.Results (1)There were statistical differences in pancreatic perfusion parameter values,namely blood flow(BF),blood volume(BV)and mean transit time(MTT),between group A and group B(P<0.05).BF and BV of group B were lower than those of group A but MTT was higher than that of group A,and there was no statistical difference in permeability surface(PS)(P>0.05).(2)For group B,each pancreas part(head,body and tail)had no statistical difference in perfusion parameter values,namely BF,BV,PS and MTT(P>0.05).(3)For group B which was divided into three groups according to Child-Pugh,there were statistical differences in parameter values BF and BV(P<0.05)among the three groups and no statistical differences in BF and BV among any two of the groups(P<0.05);there were no statistical differences in PS and MTT among the three groups.(4)In group B,there was a statistical difference in BF between the subgroup with collateral circulation and the one without collateral circulation(P<0.05),the subgroup with collateral circulation showed lower BF than that of the subgroup without collateral circulation and there were no statistical differences in BV,PS and MTT(P>0.05).Conclusion Liver cirrhosis can result in microcirculation disturbance of pancreas,the change in microcirculation varies depending on the degree of liver cirrhosis, and CT perfusion imaging is helpful to the evaluation of pancreatic microcirculation in the state of liver cirrhosis.

Objective To compare the whole brain grey matter volume(GMV)in first-episode major depressive disorder (MDD) with different age-onset. Methods 101 first-episode, drug-naive depressive patients were divided into three groups on the basis of age of MDD onset: 32 patients with early adult onset depression (18-29 years,EOD), 39 patients with middle age onset depression (30-44 years, MOD), and 30 patients with late adult onset depression (45-60 years, LOD). A total of 91 healthy controls (HCs),well matched by age and gender, were also collected into three groups: the 32 young HCs (18-29 years), the 30 middle-aged HCs (30-44 years), and the 29 late onset HCs (45-60 years). Magnetic resonance imaging was conducted on all subjects. The voxel-based morphometry (VBM) approach was employed to analyze the images. Results Compared to young HCs, the EOD group showed decreased GMV in the left thalamus, right lingual gyrus, right cuneus and cerebellumⅥ(t=-4.26--3.58,all P<0.01), and increased GMV in right angular gyrus(t=4.45,P<0.01). Compared to middle-aged HCs, the MOD group showed decreased GMV in the right middle frontal gyrus(t=-3.62,P<0.01). Compared to late onset HCs, the LOD group exhibited decreased GMV in the right middle temporal gyrus, right lingual gyrus, left fusiform gyrus and bilateral cerebellum Ⅸ(t=-4.87--3.91,P<0.01), but an increased right amygdala(t=3.36,P<0.01). The full factorial analysis revealed that the right middle frontal gyrus(t=7.40)and right cerebellum Crusl (t=7.20)were significantly different among the three patient subgroups(P<0.005,unadjusted). The whole brain GMV of EOD and MOD subgroups positively correlated with the symptom severity(r=0.553-0.641,P<0.01), while the whole brain GMV of LOD subgroup negatively correlated with their symptom severity (r=- 0.626,P<0.01). Conclusions Individuals with MDD may have the GMV reduced in the limbic-cortical-striatal-pallidal-thalamic (LCSPT) circuit. The whole GMV changes are different in MDD patients with various age-onsets. The findings may suggest different pathophysiological characteristics among first episode MDD patients with different age-onset.

Objective To compare the whole brain grey matter volume(GMV)in first-episode major depressive disorder (MDD) with different age-onset. Methods 101 first-episode, drug-naive depressive patients were divided into three groups on the basis of age of MDD onset: 32 patients with early adult onset depression (18-29 years,EOD), 39 patients with middle age onset depression (30-44 years, MOD), and 30 patients with late adult onset depression (45-60 years, LOD). A total of 91 healthy controls (HCs),well matched by age and gender, were also collected into three groups: the 32 young HCs (18-29 years), the 30 middle-aged HCs (30-44 years), and the 29 late onset HCs (45-60 years). Magnetic resonance imaging was conducted on all subjects. The voxel-based morphometry (VBM) approach was employed to analyze the images. Results Compared to young HCs, the EOD group showed decreased GMV in the left thalamus, right lingual gyrus, right cuneus and cerebellumⅥ(t=-4.26--3.58,all P<0.01), and increased GMV in right angular gyrus(t=4.45,P<0.01). Compared to middle-aged HCs, the MOD group showed decreased GMV in the right middle frontal gyrus(t=-3.62,P<0.01). Compared to late onset HCs, the LOD group exhibited decreased GMV in the right middle temporal gyrus, right lingual gyrus, left fusiform gyrus and bilateral cerebellum Ⅸ(t=-4.87--3.91,P<0.01), but an increased right amygdala(t=3.36,P<0.01). The full factorial analysis revealed that the right middle frontal gyrus(t=7.40)and right cerebellum Crusl (t=7.20)were significantly different among the three patient subgroups(P<0.005,unadjusted). The whole brain GMV of EOD and MOD subgroups positively correlated with the symptom severity(r=0.553-0.641,P<0.01), while the whole brain GMV of LOD subgroup negatively correlated with their symptom severity (r=- 0.626,P<0.01). Conclusions Individuals with MDD may have the GMV reduced in the limbic-cortical-striatal-pallidal-thalamic (LCSPT) circuit. The whole GMV changes are different in MDD patients with various age-onsets. The findings may suggest different pathophysiological characteristics among first episode MDD patients with different age-onset.

Objective To study the clinical effect, safety of stains collapse of traditional Chinese medicine (TCM) combined with tumor necrosis factor-alpha (TNF-α) antagonist-a recombinant human tumor necrosis factor receptor:Fc fusion protein (rhTNF:Fc) and sulfasalazine (SSZ) in treatment of active ankylosing spondylitis (AS). Methods A total of 98 patients of AS of Gansu Provincial Hospital were divided into two groups in random, the western medicine group (rhTNF:Fc and SSZ, n=46) and the combining group (stains collapse of TCM, rhTNF:Fc and SSZ, n=52). The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), Patient Global Assessment (PGA), Visual Analogue Scale (VAS) of night pain, VAS of total pain, time of morning stiffness, TCM symptom score, distance between occipital and wall, distance between finger and ground,
thoracic activity, Schober test, and erythrocyte sedimentation rate (ESR), C reactive protein (CRP), adverse reactions before and after treatment were observed and the clinical effect was evaluated in two groups. Results A total of 86 patients achieved the study finally, 45 patients in the combining group and 41 patients in the western medicine group. The effective rate of ASAS20 was better in the combining group than that in the western medicine group(χ2=4.814,P=0.028), the Bath ankylosing spondylitis disease activity index (BASDAI) 50 showed no significant difference between the two group (χ2=0.100,P=0.752). The total effective rate in the combining group than that in the western medicine group(χ2=3.873,P=0.049). In comparison with the same group before treatment, the above indicators were improved after treatment (P<0.05). In comparison with the western medicine group after treatment, BASFI, PGA, VAS of night pain, VAS of total pain, time of morning stiffness, TCM symptom score, distance between occipital and wall, distance between finger and ground and Schober test were getting better in the combining group (P<0.05), but BASDAI, thoracic activity, ESR, CRP were not improved in the combining group (P>0.05). The adverse reactions showed no significant difference (P>0.05). Conclusions Stains collapse of TCM combined with rhTNF:Fc was more effective than single method in treatment of AS, it can alleviated the symptoms, body signs and body function, decrease indexes of inflammation, which has dramatic effect and good safety in clinic.

Hepatocellular adenomas (HCA) are rare benign tumors of the liver, and according to the differences in molecular genetics and pathology, HCA is categorized as inflammatory hepatocellular adenoma (IHCA), HCA with hepatocyte nuclear factor 1-alpha mutation (H-HCA), HCA with β-catenin mutation (β-HCA), and an undefined type. The incidence of these four types is 40%-50%, 30%-40%, 10%-15%, and 10%, respectively. In these four types of HCA, β-HCA has high risk of bleeding and malignant transformation, while H-HCA is not likely to show malignant transformation. Therefore, the accurate diagnosis of these types of HCA is very important. This article introduces the radiological features of these types of HCA on conventional MRI and hepatocyte-targeted contrast-enhanced scan and compares these findings with other types of liver solid tumors such as focal nodular hyperplasia, nodular regenerative hyperplasia, liver cancer in non-cirrhotic patients, and fibrolamellar carcinoma of the liver. It is pointed out that MRI and hepatocyte-targeted contrast agents play an important role in the diagnosis and differentiation of HCA.

In recent years ,the diffusion magnetic resonance imaging in the study of breast cancer is in-creasing,which including diffusion weighted imaging ,diffusion tensor imaging ,intravoxel incoherent motion ,and diffusion kurtosis imaging .The emergence and development of these technologies can be noninvasive quantitative evaluation of breast tumors from the molecular level .The researchers pay more and more attention to the applica-tion of breast cancers diagnosis and differential diagnosis ,therapeutic effect ,prognosis evaluation and so on .This paper reviews the progresses of the above four technologies in the use of the breast cancer .

Objective To explore the enhancing effect of monoclonal antibody coated with anti-human CD3 and CD28 on acti-vation and transformation of peripheral blood mononuclear cell (PBMC)in vitro.Methods Human peripheral blood mononuclear cells were separated.Cells was cultured in vitro,and determined by flow cytometry.The solid phase with CD3 and CD28 antibody was coated and added in.The mature CIK cells were obtained after 12 days culturing.Results The CD4 + cells was lower in group C than those in group A(P <0.05).The CD8 + cells was higher in group C than that in group A and B(P <0.05).There was signifi-cant difference of T4/T8 between group C and group A and B(P <0.05 ).There was significant difference of NK cells between group B and group C(P <0.05).The CD25 + cells was lower in group C than that in group A (P <0.01).Conclusion CD3 antibody solid coated combined with CD28 antibody added to the suspension has more strong activation than both CD3 antibody and CD28 antibody solid coating on peripheral blood mononuclear cell.