RESUMO
Objective To investigate the epidemiological and clinical features of brucellosis in Foshan.Methods The epidemiological history,clinical manifestations,laboratory tests,treatment and outcomes of 41 patients with brucellosis from 2013 to 2016 in the First People's Hospital of Foshan were retrospectively analyzed.Results Brucellosis onsets occurred mainly from February to June [85.4％ (35/41)],and 58.5％ (24/41) of them had positive epidemic history.Irregular fever,rachialgia/arthralgia,fatigue and hepatosplenomegaly occurred in 29 (70.7％),20 (48.8％),19 (46.3％) and 16 (39.0％) of the patients,respectively.The C-reactive protein (hs-CRP) of patients infected with Brucella only was lower than that in patients infected also with other bacteria (26.72 vs 50.87 mg/L,Z =-2.300,P ＜ 0.05),but no significant difference of white blood cell counts (5.77 × 109/L vs 5.83 × 109/L),neutrophil (3.50 × 109/L vs 3.84 × 109/L) and procalcitonin (PCT,0.10 vs 0.14 μg/L) between the two groups were observed.The patients with positive epidemic history had lower white blood cell,neutrophil and monocyte counts than those who did not had epidemic history (4.73 × 109/Lvs 7.28 × 109/L,2.73 × 109/L vs 4.79 × 109/L,and 0.36 × 109/L vs 0.64 × 109/L;F =9.486,10.130,9.785,P ＜ 0.05).And no significant difference of lymphocyte counts,hs-CRP and PCT between the two groups were observed (1.57 × 109/L vs 1.73 × 109/L,29.30 vs 35.76 mg/L,and 0.15 vs 0.09 μg/L;P ＞ 0.05).All the cases were infected by Brucella melitensis,and 33 of them were sensitive to general antibiotics in vitro.There were 40 cases discharged after treatment,and 34 cases still needed to increase antibiotic treatment courses.Most patients had good outcomes.Conclusions In Foshan,patients with irregular fever and rachialgia or arthralgia,and no significantly increased inflammation index,should be aware of brucellosis.We should strengthen the screening of brucellosis in Foshan.
RESUMO
Objective To explore modification of islet cell function in type 2 diabetes by the treatment of insulin detemir and insulin aspart.Methods A total of 68 patients with diagnosed type 2 diabetes were randomized into two grouops,the control group (insulin glargine combined with insulin aspart)and observation group (insulin detemir combined with insulin aspart),each group had 34 cases.Before and after treatment,fasting insulin and 2 h postprandial insulin,glycated hemoglobin (HbA1c),C peptide and fructosamine (FMN)levels were compared in two groups,and the treatment safety was observed.Results After treatment,fasting insulin and C -peptide levels in the two groups were significantly increased than before treatment(P 0.05).In the observation group,except for 2h postprandial insulin levels,other indicators had no significant differences compared with the control group (P >0.05 ).After treatment,FMN and HbA1c in the two groups decreased significantly compared with before treatment(P 0.05).During treatment,both two groups observed hypoglycemia,but there were no severe adverse reactions.Conclusion The clinical application of insulin detemir combined with insulin aspart in the treatment of type 2 diabetes can significantly improve the insulin -producing cells and accelerate functional recovery, and the clinical effect is better than the united aspart insulin glargine,with no significant adverse reactions,it can be recommended as a clinical type 2 diabetes treatment drug of choice.