Objective To investigate the clinical efficacy of Liraglutide(Lir) combined with short-term insulin intensive therapy in newly diagnosed overweight/obese patients with type 2 diabetes mellitus (T2DM). Methods A total of 144 newly diagnosed overweight/obese patients with T2DM admitted to the Endocrinology Department of Anqing Municipal Hospital from November 2022 to October 2023 were enrolled and randomly divided into intensive treatment(Int) group and Lir group with 72 cases in each group. The intensive Int group received oral Metformin tablets combined with subcutaneous injections of insulin before meals and insulin glargine before bedtime. The Lir group received subcutaneous injections of Liraglutide in addition to the Int group. The changes in blood pressure (BP),weight,BMI,WC,WHR,blood glucose(BG),blood lipids,SUA,HOMA-IR,HOMA-β,BG target time,insulin dosage and injection frequency,number of cases of meal-time insulin discontinuation and incidence of hypoglycemia before and after 1,4,and 12 weeks of treatment were evaluated and compared between the two groups. Results After 4 and 12 weeks of treatment,the BP,weight,BMI,WC and WHR were significantly lower than before treatment in the Lir group (P<0.05). 2 hPG at 1,4 and 12 weeks after treatment was significantly lower in Lir group than in Int group (P<0.05),and HbA1c after 12 weeks of treatment were significantly lower in Lir group than in Int group[(6.49±0.41)％ vs (8.31±0.75)％,P<0.05]. After 4 and 12 weeks of treatment,HDL-C,1 hC-P and HOMA-β were significantly higher in Lir group than in Int group,while TC,TG,LDL-C,SUA and HOMA-IR was significantly lower in Lir group than in Int group (P<0.05). The time for BG to reach the standard was significantly shorter in Lir group than in Int group[(4.23±1.55) vs (6.23±1.78) d,P<0.05].After treatment for 4 and 12 weeks,the basal insulin dosage decreased significantly. After treatment for 1,4,and 12 weeks,the insulin dosage during meals,the number of subcutaneous insulin injections,and the incidence of hypoglycemia were significantly reduced in Lir group than in Int group(P<0.05).The number of patients with discontinued insulin during meals has significantly increased (P<0.05). Conclusions In newly diagnosed overweight/obese patients with T2DM,the combination of Lir and insulin intensive therapy is beneficial in controlling BP,weight,BMI,WC,WHR,BG and SUA,promoting the improvement of pancreatic β cell function,shortening the time for BG to reach the standard,reducing insulin dosage and injection frequency,and lowering the risk of hypoglycemia.

Objective To investigate the clinical efficacy of Liraglutide(Lir) combined with short-term insulin intensive therapy in newly diagnosed overweight/obese patients with type 2 diabetes mellitus (T2DM). Methods A total of 144 newly diagnosed overweight/obese patients with T2DM admitted to the Endocrinology Department of Anqing Municipal Hospital from November 2022 to October 2023 were enrolled and randomly divided into intensive treatment(Int) group and Lir group with 72 cases in each group. The intensive Int group received oral Metformin tablets combined with subcutaneous injections of insulin before meals and insulin glargine before bedtime. The Lir group received subcutaneous injections of Liraglutide in addition to the Int group. The changes in blood pressure (BP),weight,BMI,WC,WHR,blood glucose(BG),blood lipids,SUA,HOMA-IR,HOMA-β,BG target time,insulin dosage and injection frequency,number of cases of meal-time insulin discontinuation and incidence of hypoglycemia before and after 1,4,and 12 weeks of treatment were evaluated and compared between the two groups. Results After 4 and 12 weeks of treatment,the BP,weight,BMI,WC and WHR were significantly lower than before treatment in the Lir group (P<0.05). 2 hPG at 1,4 and 12 weeks after treatment was significantly lower in Lir group than in Int group (P<0.05),and HbA1c after 12 weeks of treatment were significantly lower in Lir group than in Int group[(6.49±0.41)％ vs (8.31±0.75)％,P<0.05]. After 4 and 12 weeks of treatment,HDL-C,1 hC-P and HOMA-β were significantly higher in Lir group than in Int group,while TC,TG,LDL-C,SUA and HOMA-IR was significantly lower in Lir group than in Int group (P<0.05). The time for BG to reach the standard was significantly shorter in Lir group than in Int group[(4.23±1.55) vs (6.23±1.78) d,P<0.05].After treatment for 4 and 12 weeks,the basal insulin dosage decreased significantly. After treatment for 1,4,and 12 weeks,the insulin dosage during meals,the number of subcutaneous insulin injections,and the incidence of hypoglycemia were significantly reduced in Lir group than in Int group(P<0.05).The number of patients with discontinued insulin during meals has significantly increased (P<0.05). Conclusions In newly diagnosed overweight/obese patients with T2DM,the combination of Lir and insulin intensive therapy is beneficial in controlling BP,weight,BMI,WC,WHR,BG and SUA,promoting the improvement of pancreatic β cell function,shortening the time for BG to reach the standard,reducing insulin dosage and injection frequency,and lowering the risk of hypoglycemia.

OBJECTIVE: To evaluate the safety and prognosis for patients with early esophageal cancer and precancerous lesions after endoscopic submucosal dissection (ESD).
 METHODS: A total of 89 patients were admitted to the Department of internal medicine in the First People's Hospital of Anqing from August 2008 to August 2011. All patients were treated with ESD at the early stage of esophageal cancer and precancerous lesions. The patients' laboratory data and relevant medical history were collected. The postoperative complications and long-term effects of ESD were analyzed.
 RESULTS: Eighty-nine patients were followed up with 100% response rate. Among 89 cases, 16 were early esophageal cancer, 38 were high-grade esophageal neoplasia and 35 were low-grade esophageal neoplasia. The one-time whole piece resection rate, complete resection rate and curative resection rate was 93.3% (84/89), 92.1% (82/89) and 92.1% (82/89), respectively. Two cases suffered intraoperative perforation with a rate of 2.2% and these 2 patients performed the intraoperative endoscopic repair; one case suffered the postoperative delayed bleeding with a rate of 1.1% and the patient underwent the conservative treatment; three cases suffered the esophageal stenosis with a rate of 3.4%. All patients were followed-up for 10-58 (36.3±21.2) months. In this period, one case recurred after ESD for 3 years with a rate of 1.1%; two cases were dead. The three-year survival rate was 97.8%.
 CONCLUSION The early esophageal cancer and precancerous lesions can be treated with ESD. The method is safe and the prognosis is good.
Dissection ; Endoscopy ; adverse effects ; Esophageal Neoplasms ; surgery ; Esophageal Perforation ; Esophageal Stenosis ; Humans ; Postoperative Complications ; Postoperative Hemorrhage ; Prognosis

Objective To compare the differences in the use of effects of improved and traditional abdominal positioning locator card in the empty nest elderly diabetic patients with insulin pen injection. Methods 100 discharged cases of empty nest elderly diabetic patients with insulin treated were enrolled. They were divided into two groups by random digital table method, 50 cases in traditional positioning card injection group and 50 cases in improved positioning card injection group. Usage rate of two sets of locator cart, adverse reactions in local skin injection and blood glucose control were observed for 12 months. Results After 12 months, 44 cases occupied 88%in improved positioning card injection group were not about using positioning card while 30 cases occupied 60%in traditional positioning card injection group. The difference was statistical significance (P<0.05). After 12 months, only 3 cases in improved positioning card injection group appeared local injection site reactions which was significantly lower than 31 cases in the traditional positioning card injection group, and the difference was statistically significant (P<0.05);12 months later, fasting blood glucose (FBG), 2 hour postprandial blood glucose (2 h PBG), glycosylated hemoglobin (HbA 1c) of improved positioning card injection group and traditional positioning card injection group [(7.0 ±1.5) mmol/L and(7.8±1.9)mmol/L,(10.7±2.1)mmol/L and(12.3±2.2)mmol/L,(7.1±1.3)% and(7.7±1.5)%] were all decreased significantly than before. The difference was statistically significant (P<0.05). FBG,2 h PBG, HbA1c of improved positioning card injection group were decreased more significantly than that in traditional positioning card injection group and the difference was statistically significant (P<0.05). The standard rate of HbA1c [64% (32/50)] in improved positioning card injection group was higher than that in traditional positioning card injection group [42%(21/50)]. The difference was statistically significant (P<0.05). Conclusions The modified abdominal injection locator card can improve patients′positioning card usage rate, optimize insulin injection technique, reduce the occurrence of adverse reactions in local skin injection and improve the control of blood glucose.