Objective To evaluate whether serum complement C3 concentration was associated with the prevalence and incidence of prediabetes in an adult population. Methods A cross-sectional (n=10 539) and prospective cohort (n=3 064, followed up for-6 years, mean:2.8 y) study was performed on subjects recruited from the Health Management Center of Tianjin Medical University General Hospital in Tianjin. Measurements of serum C3 concentration, blood fasting glucose and other potential confounding factors were assessed at baseline and per year during the follow-up period. Prediabetes was defined according to the criteria of American Diabetes Association. Adjusted Logistic and Cox proportional hazards regression models were used to assess the associations between C3 quintiles and prediabetes. Results The prevalence and incidence of prediabetes were 19.9% and 99.5 per 1 000 person-year, respectively. In cross-sectional analysis, after adjusted for potential confounders, the odds ratios (95% confidence interval) of prediabetes for increasing quintiles of C3 were 1.00 (reference), 1.18 (0.98-1.42), 1.11 (0.92-1.34), 1.38 (1.15-1.65) and 1.63 (1.36-1.95) (P for trend<0.000 1). In cohort analysis, in the final multivariate models, the hazard ratios (95% confidence interval) for prediabetes across C3 quintiles were 1.00 (reference), 1.20 (0.94-1.54), 1.48 (1.16-1.88), 1.38 (1.09-1.76) and 1.53 (1.21-1.95) (P for trend <0.001), respectively. Conclusion The study suggests that the elevated C3 level is significantly associated with the prevalence and incidence of prediabetes, which means that C3 can be used as a biomarker in early prevention of prediabetes and diabetes.

Objective To investigate the effects of dilute concentration and acting time of pronase on quality of gastroscopy.Methods A total of 448 patients were randomly divided into two groups : sodium bicarbonate group and pronase with sodium bicarbonate group.Pronase was diluted into 50 ml (400 U/ml)and 100 ml (200 U/ml) using sodium bicarbonate.The patients were pretreated by pronase of different concentrations 10 min, 20 min, 30 min, 60 min and 120 min before gastroscopy.Diluent of same quantity were taken by the control group.Visibility of gastroscopy, procedure times and positive rates of lesions were compared.Results Pretreatment of pronase significantly improved visibility of gastroscopy, raised positive rates of lesions, and reduced procedure times of gastroscopy, compared with the control group (each P ＜ 0.05).The visibility of gastroscopy were over 80％ 20,30, and 60 minutes before the examination with no significant difference(P ＞ 0.05).The visibility of gastroscopy decreased sharply 30 minutes after taking pronase, especially after 60 minutes.There was no significant difference in the quality of gastroscopy between the 200 U/ml and 400 U/ml group 20-60 minutes before gastroscopy (P =0.640).Conclusion Pronase (200 U/ml-400 U/ml) significantly improves visibility of gastroscopy, raises positive detection rates of lesions, and reduces procedure time of gastroscopy 20-60 minutes before pretreatment.

ObjectiveTo evaluate the value of serum galactomannan platelia aspergillus kit in the diagnosis and treatment of invasive fungal infection(IFI) patients. MethodsA total of 178 serum samples from 74 high risk patients were collected. ELISA assay was used to detect the level of GM antigen. Refer to domestic IFI diagnostic criteria, 16 patients include the proven cases and probable cases were defined as study group, while 29 patients of improbable cases defined as control group. Fourflod table was founded,by which the sensitivity,specificity,positive predictive value, negative predictive value of this GM test were calculated. Meanwhile, a total of 53 patients received antifungal therapy which divided into GM-positive group(21 patients with I≥0. 5) and GM-negative group(32 patients with I ＜0. 5). The therapeutic effect comparison of two groups was made according to curative effect criterion. ResultsAccording to the certainty level of IFI diagnosis, 1,9,10 and 4 patients were identified as GM positive in proven, probable,possible and improbable IFI groups respectively. The prevalence of GM in these 4 groups was 50％ ,64％ ,34％ and 14％ ,respectively. The sensitivity and specificity of galactomannan ELISA assay were 63％ ,86％ respectively. The positive and negative predictive values were 71％ and 81％ respectively. The diagnose accordance rate was 78％, the Younden index was 0. 49. The efficacy of fluconazole in GM-positive patients was significant lower than in GMnegative patients( x2 =4. 95 ,P ＜0. 05) ,while The efficacy of non-fluconazole drug was superior to that in GM-negative patients( x2 =4. 88,P ＜ 0. 05). After antifungal therapy, the GM value of GM-positive patients decreased significantly( t =2. 13 ,P ＜0. 05). ConclusionThe galactomannan ELISA assay with high specificity, could be helpful in diagnosis and choicing effective anti-fungi drug in clinic.

Objective To discuss the safety and the application of the self-designed multifunctional inflatable pelvis and hip-joint fixator (MIPHF) in damage control in pelvic fracture patients.Methods The MIPHF was subjected to pressure test and quality inspection.From September 2016 to June 2017,61 pelvic-fracture patients were treated with our self-designed MIPHF as pre-hospital first-aid care according to the concept of damage control orthopedics (DCO) (MIPHF group).The control group consisted of 69 pelvic-fracture patients who had not received pre-hospital first-aid care with the self-designed MIPHF from December 2015 to August 2016.There were no statistically significant differences between the two groups in gender,age,types of pelvic fracture,and preoperative injure severity score (ISS).The study compared the two groups for the case fatality rate,volume of blood transfused during surgeries,early complication rates,fracture reduction (Matta standards),and long-term efficacy (Cole scores).Results The pressure test showed that the MIPHF had a good fixation effect on the pelvis.And the quality inspection showed that the material used for the MIPHF was in line with national standards and the safety was guaranteed.The MIPHF group had 1 death (1.6％) and the control group had 8 deaths (11.6％),which was a significant difference (x2=4.979,P=0.026).All survival patients in both groups were followed up.The MIPHF group (61 cases) received 3.0 to 18.0 months follow-up,with an average of 9.0 months.And the control group (69 cases) had 18.0 to 30.0 months follow-up,with an average of 21.9 months.In the MIPHF group,23 cases were treated conservatively,and 37 cases were treated with surgery.Among them,3 cases were fixed with external fixator,20 cases with anterior open reduction and internal fixation,9 cases with posterior open reduction and internal fixation,and 5 cases with combined anterior and posterior fixation.The timing of surgery was 1 to 20 days after injury,with an average of 4.1 days.The volume of blood transfused in the MIPHF group during surgery was 200 to 1500 ml,with an average of 628.6 ml.In the control group,27 patients were treated conservatively,and 42 patients were treated with surgery.Among them,2 cases were fixed with external fixator,24 cases with anterior open reduction and internal fixation,10 cases with posterior open reduction and internal fixation,and 6 cases with combined anterior and posterior fixation.The timing of surgery was 1 to 15 days after injury,with an average of 3.l days.The volume of blood transfused in the control group during surgery was 200 to 4000 ml,with an average of 1 707.1 ml.There was a significant difference between the two groups in intraoperative blood transfusion(Z=-2.330,P=0.020).The MIPHF group had 10 (16.4％) cases of early serious complications and the control group had 22 (31.9％) cases,which had a significant difference (x2=4.187,P=0.041).According to the criteria proposed by Matta et al.,the good rate of results for treating fractures was 82.0％ in the MIPHF group and 60.9％ in the control group,which got a significant difference (x2=6.967,P=0.008).The MIPHF group and the control group also differed significantly in their mean long-term Cole scores (27.2±4.0 versus 25.1 ±5.6,t=2.457,P=0.015).Conclusion MIPHF,which reflects the DCO concept,may be recommended as pre-hospital first-aid care for patients with pelvic fracture because it can lessen bleeding and prevent secondary pelvic injury,thus reduce case fatality rate and the incidence of complications.It can also improve the success rate of treating pelvic fracture,which will positively affect long-term outcomes.