【摘要】 目的 了解不同糖代谢状态的人群空腹及口服葡萄糖耐量实验（oral glucose tolerance test，OGTT）餐后胰高血糖素样态-1（GLP-1）和葡萄糖依赖的促胰岛素多态（GIP）水平。 方法 将受试者根据OGTT结果分为3组:正常糖耐量组（NGT，n=61例），糖耐量受损组（IGT，n=53）和2型糖尿病组（T2DM， n=66）。采空腹及糖餐后2 h静脉血检测GLP-1和GIP水平。 结果 T2DM组空腹GLP-1水平低于NGT和IGT组（Plt;0.05）。NGT和IGT的空腹GLP-1水平差异无统计学意义（Pgt;0.05）。餐后GLP-1水平三组差异无统计学意义（Pgt;0.05）。空腹及餐后GIP水平在NGT、IGT和T2DM均呈逐渐增加的趋势，而且同OGTT-0 h和OGTT-2 h血糖水平呈正相关（r=0.384，0.426；Plt;0.05）。 结论 不同的GLP-1和GIP水平也许是IGT和T2DM胰岛素分泌能力不同的原因之一。【Abstract】 Objective To investigate the fasting, and after oral glucose tolerance test (OGTT), the postprandial levels of glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) in Chinese people with different degrees of glucose tolerance. Methods Based on the results of OGTT, 180 subjects were divided into three groups: normal glucose tolerance group (NGT group, n=61), impaired glucose tolerance group (IGT group, n=53) and type-2 diabetes mellitus group (T2DM group, n=66). Fasting venous blood and the venous blood 2 hours after OGTT was sampled to detect GLP-1 and GIP levels. Results The fasting GLP-1 level in the T2DM group was significantly lower than that in the NGT and IGT groups (Plt;0.05). There was no significant difference in fasting GLP-1 level between NGT and IGT groups (Pgt;0.05). There was no significant difference in GLP-1 level 2 hours after OGTT among all the three groups (Pgt;0.05). GIP level gradually increased in the order of NGT, IGT and T2DM both before and after glucose load, and it was positively correlated with glucose levels just after OGTT and 2 hours after OGTT (r=0.384,0.426;Plt;0.05). Conclusion Different GLP-1 and GIP levels may be one of the reasons for different insulin secretion ability between IGT and T2DM
In recent years, immune checkpoint inhibitor therapy has changed the treatment of various malignant tumors. Immunotherapy for specific targets currently plays an important role in melanoma, lung cancer and other tumors. Malignant pleural mesothelioma (MPM) is an aggressive malignant tumor. Although the treatments include surgery, chemotherapy and radiotherapy, the clinical efficacy is limited, and the prognosis of advanced patients is poor. With the application of monoclonal antibodies such as programmed death 1/programmed death ligand 1 and cytotoxic T-lymphocyte antigen 4, MPM patients have more treatment options. And compared with traditional chemotherapy, immunotherapy may have the effect of improving survival and shrinking tumors. This article will summarize the current clinical trials of immunotherapy in MPM, and explain the current application and progress of immunotherapy in MPM from both single-agent immunotherapy and combined immunotherapy.
ObjectiveTo investigate the clinical efficacy of preoperative location of pulmonary nodules guided by electromagnetic navigation bronchoscopy (ENB). MethodsPatients who received preoperative ENB localization and then underwent surgery from March 2021 to November 2022 in the Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine were collected. The clinical efficacy and safety of ENB localization and the related factors that may affect the success of ENB localization were analyzed. ResultsInitially 200 patients were included, among whom 17 undergoing preoperative localization and biopsy were excluded and a total of 183 patients and 230 nodules were finally included. There were 62 males and 121 females with a mean age of 49.16±12.50 years. The success rate of navigation was 88.7%, and the success rate of ENB localization was 67.4%. The rate of complications related to ENB localization were 2.7%, and the median localization time was 10 (7, 15) min. Multi-variable analysis showed that factors related to successful localization included distance from localization site (OR=0.27, 95%CI 0.13-0.59, P=0.001), staining material (OR=0.40, 95%CI 0.17-0.95, P=0.038), and staining dose (OR=60.39, 95%CI 2.31-1 578.47, P=0.014). Conclusion ENB-guided preoperative localization of pulmonary nodules is safe and effective, and the incidence of complications is low, which can be used to effectively assist the diagnosis and treatment of early lung cancer.
Surface electromyogram (sEMG) may have low signal to noise ratios. An adaptive wavelet thresholding technique was developed in this study to remove noise contamination from sEMG signals. Compared with conventional wavelet thresholding methods, the adaptive approach can adjust thresholds based on different signal to noise ratios of the processed signal, thus effectively removing noise contamination and reducing distortion of the EMG signal. The advantage of the developed adaptive thresholding method was demonstrated using simulated and experimental sEMG recordings.
The precise localization of pulmonary nodules has become an important technical key point in the treatment of pulmonary nodules by thoracoscopic surgery, which is a guarantee for safe margin and avoiding removal of too much normal lung parenchyma. With the development of medical technology and equipment, the methods of locating pulmonary nodules are also becoming less trauma and convenience. There are currently a number of methods applied to the preoperative or intraoperative localization of pulmonary nodules, including preoperative percutaneous puncture localization, preoperative transbronchial localization, intraoperative palpation localization, intraoperative ultrasound localization, and localization according to anatomy. The most appropriate localization method should be selected according to the location of the nodule, available equipment, and surgeon’s experience. According to the published literatures, we have sorted out a variety of different theories and methods of localization of pulmonary nodules in this article, summarizing their advantages and disadvantages for references.