One of the effective and consistent ways to achieve glycaemic control for patients with type 2 diabetes mellitus (T2DM) is once‐daily basal insulin. But it is also associated with adverse outcomes such as hypoglycaemia. Dulaglutide, a novel long‐acting GLP‐1 receptor agonist, may be a more suitable therapy. The present meta‐analysis aims to assess the efficacy and safety of once‐weekly glucagon‐like peptide‐1 receptor agonist dulaglutide compared with insulin glargine for the treatment of T2DM.

Background: Human epidermal growth factor receptor 2 (HER2) is an overexpressed antigen in esophageal squamous cell carcinomas (ESCCs) but with limited expression levels in normal esophageal tissues. Therefore, employing the adoptive transfer of T cells genetically modified to express chimeric antigen receptor (CAR) targeting HER2 could be a promising therapeutic strategy against ESCC. Methods: Two different second-generation CAR-T cells expressing antibodies for HER2 and CD19 antigens were developed using retroviral vector transduction. The expression of HER2 antigen in ESCC tissue and cell lines was examined by immunohistochemistry and flow cytometry, respectively. The tumor killing efficacy of the CAR-T cells in mice model and ESCC cell lines and its potential for the treatment of ESCC was evaluated by determining tumor size in mice xenograft, and by crystal violet staining, MTS assay, and cytokine release. Results: In vitro, HER2.CAR-T cells efficiently recognized and killed HER2-positive tumor cells as evidenced by the secretion of proinflammatory cytokines, interferon-γ, and interleukin 2 and by cytotoxicity assays. In vivo, intratumor injection of HER2.CAR-T cells resulted in a significant suppression of established ESCCs in a subcutaneous xenograft BALB/c nude mouse model. In contrast, the injection of CD19.CAR-T cells did not affect the tumor growth pattern. Conclusions: An effective HER2 CAR targeting ESCC was developed successfully. The HER2.CAR-T cell showed promising immunotherapeutic potential for the treatment of HER2-positive esophageal cancer.

Objective: To investigate the efficacy of the fasting insulin (Fins)/fasting C peptide (FC-P) ratio and the postprandial 2 h insulin (2 h Ins)Ipostprandial 2 h C-peptide (2 h C-P) ratio in predicting insulin antibody (IA) in type 2 diabetes mellitus. Methods: IA was detected in a random selection of 152 patients with type 2 diabetes mellitus who were treated in our hospital from February 2017 to September 2018. The patients were divided into an IA expression positive group and an IA expression negative group according to whether IA expression was positive or not. There were 91 cases in the IA expression positive group and 61 cases in the IA expression negative group. Fins, FC-P, the Fins/FC-P ratio, 2 h Ins, 2 h C-P and the 2 h Ins/2 h C-P ratio were detected by enzyme-linked immunosorbent assay. The correlation between the Fins/FC-P ratio and the 2 h Ins/2 h C-P ratio and IA expression was analysed by the Pearson correlation test analysis. The predictive value of the Fins/FC-P ratio and the 2 h Ins/2 h C-P ratio in predicting IA in type 2 diabetes mellitus were analysed. Results: Compared with the IA expression negative group, the Fins and Fins/FCP ratios in the IA expression positive group were significantly increased (P<0.01) and there was no statistically significant difference in FC-P level between the two groups (P>0.05). The 2 h Ins and 2 h InsI2 h C-P ratio in the IA expression positive group was significantly higher than that in the IA expression negative group (P<0.01) and there was no significant difference between the two groups of 2 h C-P levels (P>0.05). The results of the Pearson correlation test showed that the expression of IA was positively correlated with Fins, the Fins/FC-P ratio, 2 h Ins, and the 2 h Ins/2 h C-P ratio (P<0.05), but there was no significant correlation with FC-P and 2 h C-P (P>0.05). The ROC curve was established, and the results showed that the areas under the curve of Fins, Fins/FC-P, 2 h Ins and 2 h Ins/2 h C-P were 0.805, 0.882, 0.739 and 0.866, respectively. The specificity and sensitivity of Fins/FC-P are high, and the predictive value of IA in type 2 diabetes mellitus is higher. Conclusion: The ratios of Fins/FC-P and 2 h Ins/2 h C-P have a certain predictive value for IA in type 2 diabetes mellitus, and the ratio of Fins/FC-P has the higher predictive value.

Department of Biochemistry and Molecular Biology, Shanxi Medical University, Taiyuan, Shanxi 030001, China; Department of Clinical Laboratory, First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, China; Department of Central Laboratory, Affiliated Pulmonary Hospital of Shanxi Medical University, Taiyuan, Shanxi 030053, China; Department of Disease Detection, Shanxi Provincial Center for Disease Control and Prevention, Taiyuann, Shanxi 030001, China; Department of Infectious Diseases, First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, China; Department of Internal Medicine, Affiliated Pulmonary Hospital of Shanxi Medical University, Taiyuan, Shanxi 030053, China; Department of General Surgery, First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, China.

Objective: To investigate the effect of insulin on peripheral adiponectin (APN), glucagon and fibrinogen in patients with type 2 diabetes mellitus (T2DM). Methods: Eighty patients with T2DM, who were admitted to our Department of Endocrinology from July 2016 to August 2017, were enrolled in the study and randomly assigned into the study group and the control group. The control group was orally given acarbose tablets or metformin. Further, the group was administrated with insulin on the basis of the control group, and the dose was adjusted according to the blood glucose level. Changes in blood glucose levels (fasting blood glucose, 2 h postprandial blood glucose) and the glycosylated hemoglobin (HbA1c) levels of the two groups were observed before and after treatment. Besides, changes in peripheral adiponectin (APN), the fibrinogen and insulin secretion index (HOMA-beta), as well as the insulin resistance of the two groups were observed before and after treatment. The glucagon levels of the patients at 15, 30, 60, 90 and 120 minutes after taking the drugs were measured, and the incidence of hypoglycemia was recorded in the two groups as well. Results: Fasting blood glucose (FBG), 2 h postprandial blood glucose (2hPBG), HbA1c and fibrinogen levels, were much lower in the study group than those in the control group after treatment (P<0.05). However, the APN level was much higher in the study group than that in the control group (P<0.05). In addition, HOMA-beta was much higher in the study group than that in the control group, while HOMA-IR was much lower in the study group than that in the control group. Further, the difference was statistically significant (P<0.05). The glucagon level declined greatly in the study group at 15 min after taking the drugs, which was decreased much more than that in the control group. Conclusions: Insulin can largely control the blood glucose level of patients with T2DM, greatly increase APN, improve insulin resistance, reduce the secretion of glucagon and depress the concentration of fibrinogen, thereby controlling the progression of diabetes.

Tranexamic acid might be beneficial for cerebral hemorrhage. However, the results remained controversial. We conducted a systematic review and meta-analysis to explore the influence of tranexamic acid on cerebral hemorrhage. PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) assessing the effect of tranexamic acid on cerebral hemorrhage were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. This meta-analysis was performed using the random-effect model. Seven RCTs involving 1702 patients were included in the meta-analysis. Overall, compared with control intervention in cerebral hemorrhage, tranexamic acid could significantly reduce growth of hemorrhagic mass (RR = 0.78; 95% CI = 0.61-0.99; P = 0.04) and unfavorable outcome (RR = 0.75; 95% CI = 0.61-0.93; P = 0.008), but demonstrated no substantial influence on volume of hemorrhagic lesion (Std. MD = - 0.10; 95% CI = - 0.27 to 0.08; P = 0.28), neurologic deterioration (RR = 1.25; 95% CI = 0.60-2.60; P = 0.56), rebleeding (RR = 0.62; 95% CI = 0.35-1.09; P = 0.10), surgery requirement (RR = 0.78; 95% CI = 0.40-1.51; P = 0.46), and mortality (RR = 0.86; 95% CI = 0.69-1.05; P = 0.14). Compared to control intervention in cerebral hemorrhage, tranexamic acid was found to significantly decrease growth of hemorrhagic mass and unfavorable outcome, but showed no notable impact on volume of hemorrhagic lesion, neurologic deterioration, rebleeding, surgery requirement and mortality.

In this paper, aimed at reducing deviation of the output characteristic between DFIG model and operating wind turbine generator. A method using measured data for modifying the model of DFIG is provided. Firstly, the data fitting method is used to get the mathematical model of the operating turbine. Secondly, the model is studied to improve its control strategy. At last, an example is given in PSCAD and showed that the modified model truthfully reflects the output characteristics of the operating wind turbine generator which improved the integration simulation accuracy of DFIG.

The connection of wind farm causes influence on the power system voltage stability because of the volatility and intermittency of wind power.In this paper, based on researching a regional wind farm, the influence of power fluctuation on power system voltage is analyzed.The influences of different settings of manual (mechanical) switched capacitor, SVC and STATCOM to the improving of power grid voltage are analyzed by PSCAD.Meanwhile, the improvement effects of the power grid voltages with different reactive power compensation devices are calculated by contrasting the curves of bus voltage volatilities during the increasing of wind power from 0 to 100% with different conditions.

Objective: To explore the relationship between the general self - efficacy and job alienation among clinical nurses in China. Methods: The Gerneral self - efficacy scale and the Work Alienation of nurse scale was used to investigate the clinical nurses in Shiyan City, Hubei Province. Results: The study showed that the self - efficacy and job alienation of clinical nurses were (24.18 +/- 5.30) and (34.22 +/- 7.02), General self - efficacy was related to job alienation negatively. Conclusion: The higher self- efficacy of clinical nurses was higher.

Objective To observe the clinical effects of transitional care intervention on patients with diabetic foot ulcer(DFU), so as to provide nursing evidence for clinical. Methods The literatures of randomized controlled trials (RCT) on the transitional care intervention on patients with diabetic foot ulcer were searched electronically in national and international medical databases from database created to 31st January 2017. The modified Jadad scale was used to evaluate methodological quality. Rev Man 5.3.1 software was used for the Meta-analysis. Results A total of 16 RCTs were enrolled in this Meta-analysis. The Meta-analysis showed that transitional care intervention on patients with DFU was more effectively in improving self-efficacy compared routine nursing [SMD=1.75, 95%CI(1.28, 2.22), P< 0.001], promoting the master of the hypoglycemic knowledge [SMD=1.94, 95%CI(0.79, 3.09), P=0.001]and daily foot care knowledge [SMD=1.87, 95%CI (1.44, 2.30), P< 0.001],decreasing the fasting blood glucose [MD=-0.87, 95%CI(-1.11, -0.63), P<0.001]and 2 hours postprandial blood glucose [MD=-1.43,95%CI(-1.85, -1.01),P<0.001], reducing the glycosylated hemoglobin [MD=-0.84, 95%CI(-1.41, -0.27), P=0.004],as well as decreasing the DFU infection rate [RR=0.26, 95%CI(0.11, 0.60), P=0.004]and DFU recurrence rate [RR=0.20, 95%CI(0.05, 0.73), P=0.020]. Conclusions Currently, published evidence from RCTs suggests that transitional care intervention on patients with DFU is superior to conventional nursing; however, available studies are not adequate to draw a conclusion on the superiority and effectiveness of transitional care intervention on DFU due to the methodological flaws of the included trials. Hence, people could provide useful experience on further studies which are multiple centered and have big sample to confirm our findings.

High-affinity nicotinic receptors containing β2 subunits (β2*) are widely expressed in the brain, modulating many neuronal processes and contributing to neuropathologies such as Alzheimer's disease, Parkinson's disease and epilepsy. Mutations in both the α4 and β2 subunits are associated with a rare partial epilepsy, autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE). In this study, we introduced one such human missense mutation into the mouse genome to generate a knock-in strain carrying a valine-to-leucine mutation β2V287L. β2V287L mice were viable and born at an expected Mendelian ratio. Surprisingly, mice did not show an overt seizure phenotype; however, homozygous mice did show significant alterations in their activity–rest patterns. This was manifest as an increase in activity during the light cycle suggestive of disturbances in the normal sleep patterns of mice; a parallel phenotype to that found in human ADNFLE patients. Consistent with the role of nicotinic receptors in reward pathways, we found that β2V287L mice did not develop a normal proclivity to voluntary wheel running, a model for natural reward. Anxiety-related behaviors were also affected by the V287L mutation. Mutant mice spent more time in the open arms on the elevated plus maze suggesting that they had reduced levels of anxiety. Together, these findings emphasize several important roles of β2* nicotinic receptors in complex biological processes including the activity–rest cycle, natural reward and anxiety.

In this work, FPGA implementation of the compression function for four of the second round candidates of the SHA-3 competition are presented. All implementations w ere performed using the same technology and optimization techniques to present a fair comparison between the candidates. Achieved results are compared with similar implementations to provide a comprehensive comparison of candidates performance in hardware.

A new reaction system for the N-debenzylation of benzylamines 1 using Pd/C catalyst and ClCH2CHCl2 (3) directly leading to amine hydrochlorides 2 was developed. The reaction proceeds through the hydrodechlorination of 3, benzylamine˙HCl salt formation, and N-debenzylation (hydrogenolysis). Thus, the reaction of 1 with 3 was carried out in the presence of 10% Pd/C in MeOH under an atmospheric pressure of hydrogen to give the corresponding amine hydrochlorides 2 (18 examples, 94-99% yield).

To analyze the clinical and dosimetric risk factors for acute esophageal toxicity (AET) in non-small-cell lung cancer (NSCLC) patients treated with three-dimensional conformal radiotherapy (3D-CRT). One hundred and two NSCLC cancer patients treated with 3D-CRT were retrospectively analyzed. Patient characteristics were as follows: 86 males and 16 females; median age 61 year (range, 26∼78); tumor stage I-11, II-4, IIIa-40, IIIb-37, IV-10; median corrected dose-60 Gy (range, 26-74.8); BID fractionation-11 (10.8%); chemotherapy-76 (74.5%), including 36 sequential chemotherapy and 40 concurrent chemotherapy. Acute esophageal toxicity was scored according to the Radiation Therapy Oncology Group (RTOG) criteria with Grade 2 or worse considered clinically significant. The parameters analyzed included gender; age; pathological type; allergic history; smoking history; Karnofsky performance score; pretreatment weight loss; tumor stage; lymph nodes stage; short-term effectiveness; concurrent chemo-radiotherapy (CRT) ; sequential CRT; myelosuppression; BID fractionation; the maximum and mean dose to the esophagus; the percentages of organ volume receiving >15 Gy (V15), >20 Gy (V20), >25 Gy (V25), >30 Gy (V30), >35 Gy (V35), >40 Gy (V40), >45 Gy (V45), >50 Gy (V50), >55 Gy (V55) and >60 Gy (V60). Spearman's rank correlation was used to correlate the esophageal toxicity score with clinical and dosimetric factors. All risk factors that correlated with AET were tested in a stepwise logistic regression model. There were no grade 4 or 5 AET. Thirty four of 102 patients (33.3%) developed grade2 or 3 AET, 19 developed Grade 2 and 15 Grade 3. Spearman's rank correlation analyses showed that lymph nodes stage (N 0/1 vs. N 2/3), pretreatment weight loss, concurrent chemotherapy, BID fractionation, the maximum and mean dose to the esophagus and all Vdose parameters were significantly associated with Grade2 or 3 AET (p < 0.05). Thirty of 68 lymph nodes stage N2/3 patients (44.1%) , 20 of 40 concurrent chemotherapy patients (50%), 7 of 11 BID fractionation patients (63.6%) developed acute Grade 2 or 3 AET. On multivariate logistic regression analysis, V55 (p < 0.01), concurrent chemotherapy (p < 0.01), and lymph nodes stage (p < 0.05) emerged as statistically most significant correlates of AET. V55, concurrent chemotherapy and lymph nodes stage were the most statistically significant risk factors associated with radiation-induced acute esophageal toxicity.

This paper discusses the construction of quasiorthogonal codes based on Gold or Kasami sets, and orthogonal code sets with variable length based on M-sequences for CDMA systems. Quasi-orthogonal codes are used to complement orthogonal codes. Orthogonal sets from variable length Msequences are employed to ease the OVSF code blocking. Correlation performance is assessed for the proposed code sets. Numerical results show that the cross correlations are relatively low and, hence, code limitation and code blocking can be reasonably alleviated if the proposed code sets are used.

Silver nanowires with different diameters were synthesized by a hydrothermal chemical method. The elastic properties of the nanowires with outer diameters ranging from 20 to 140 nm were measured using contact atomic force microscopy. The apparent Young modulus of the nanowires is found to decrease with the increase of the diameter. When the diameter of the silver nanowires is larger than 100 nm, the Young modulus approaches a constant value. The size dependence of the apparent Young modulus of the silver nanowires is attributed to the surface effect, which includes the effects of the surface stress, the oxidation layer, and the surface roughness. Thus, a theoretical analysis is presented to explain the size dependence. This analysis is different from the previous models in that both the surface stress and the surface moduli are included in it. We also show that the apparent surface modulus and the surface stress of the silver nanowires can be experimentally determined.