Objective To examine plasma levels of protease C1 inhibitor (SERPING1) in adult patients with latent autoimmune diabetes (LADA), and their clinical significance thereof. Methods The levels of SERPING1 were detected and compared between LADA, type 1 diabetes (T1DM), type 2 diabetes (T2DM) and healthy control groups. The correlation between plasma levels of SERPING1 and other clinical indicators such as age, disease course, glycosylated hemoglobin (HbA1c), fasting blood glucose (FPG), 2 h postprandial plasma glucose (2 hPG), fasting c-peptide (FCP) and 2 h postprandi-al C peptide (2 hCP) was analyzed. Multi-factor regression analysis and receiver operating characteristic (ROC) were used to evaluate the predictive effect of SERPING1 in LADA at the early stage. Results The level of SERPING1 was significantly higher in LADA group than that of T2DM group and control group (P < 0.05). There was a negative correlation between SERPING1 and FCP, and a positive correlation between SERPING1 and HbA1c, FPG and 2 hPG (P<0.05). There were no significant correlation between SERPING1 and age, disease course and 2 hCP. FCP was analyzed by regression equation (P<0.05), and which was the main influence factor of the plasma level of SERPING1. The area under the ROC curve (AUC) of SERPING1 was 0.613 (P<0.05), 95%CI 0.514-0.712. The optimal cut-point of SERPING1 for early prediction of LADA was 289.71 mg/L, and the sensitivity and specificity were 69%and 48%respectively. Conclusion SERPING1 combined with other indicators will be useful for identifying LADA from T2DM at the early stage.

Objective To investigate the readiness for hospital discharge of patients who had undergone spinal operation at West China Hospital, Sichuan University, to guide the medical care and health education. Methods A total of 164 patients after spinal operation who have readying to discharge were selected and investigated by General Information Questionnaire, Activity of Daily Life Scale and Readiness for Hospital Discharge Scale. Apply the Excel for data inputting, SPSS19.0 for statistical analysis and choose rate, x±s and so on for statistical description according to the types of data. Results Of all the 164 patients, 47 cases (28.7%) weren′t well prepared, 117 cases (71.3%) were well prepared;the score of
Readiness for Hospital Discharge Scale was (142.38±34.23 points and the average score of all the articles was (7.12±1.72) points. Conclusions The readiness for hospital discharge score of patients who had undergone a spinal operation at West China Hospital, Sichuan University is low and their readiness for hospital discharge is inadequate. Medical staff can improve the patients′readiness for hospital discharge by strengthening health guidance in order to promote the recovery of patients.

Objective:To investigate the risk factors of musculoskeletal disorders(MSDs)in dental postgraduates.Methods:271 dental postgraduates majoring in five different specialties(orthodontics,prosthodontics,endodontics,periodontics and alveolar surgery) with average (2.78 ±1 .57)years of clinical practice were recruited.254 age-matched non-dental postgraduates were served as the controls.The standardized Nordic questionnaire on MSDs and a self-report questionnaire regarding correlative factors were answered. Reliability of the responses was assessed by applying test-retest method.Results:The test-retest method revealed a high reliability of participants'answers with the intraclass correlation coefficient ranging from 0.89 to 0.96.Dental postgraduates had significantly higher incidence (85.6%)of MSDs than the controls(70.4%).In all included dental specialties,high prevalence of MSDs was reported at neck (47.5%-69.8%),followed by shoulders (50.8%-65.1 %),lowerback (27.1 %-51 .2%)and upper back (25.6%-46.5%).Meanwhile,the high prevalence of MSD varied in different specialties.Year of clinical work,clinical hours per week and desk hours per week were found to be the risk factors for MSDs,whereas physical exercise and rest were protective factors.Conclu-sion:MSDs with high prevelence and distinct specialty-related characteristics initiate at the early stage of dental career.Relevant measures to prevent and protect against MSDs should be taken during school-days.

Objective To observe the effect of Buzhong Yiqi Decoction medicated serum on PI3K、AKT、survivin in lung adenocarcinoma A549/DDP cells,and explore its functional mechanism.Methods Buzhong Yiqi Decoction medicated serum of middle dosage (0.576 g/mL)were prepared,and A549/DDP cells were divided into four groups:blank serum group,the best containing medicine serum group and LY294002 group (blockers group), the best containing medicine serum +LY294002 group (combination group).The protein expression of PI3K,AKT and Survivin were detected by Immunocytochemistry and Western blot.Results Compare with blank serum group,the protein expression of PI3K、AKT and Survivin in best containing medicine serum and combination group were significantly lower(P<0.05 ),and the later was more lower,but there was no significant differences between best containing medicine serum and combination group.The expression of survivin in LY294002 group were significantly lower than blank serum group(P<0.05 ).Conclusion Buzhong Yiqi Decoction can reduce the protein expression of PI3K,AKT and surviving,increase the sensitivity of A549/DDP to DDP through PI3K/AKT signal transduction pathway.

Objective To discuss the diagnosis and early intervention treatment of fetal congenital broncho-genic cysts based on the cases reviewed. Methods The clinical features of 7 infants presenting bronchogenic cysts diagnosed antenatally from January 2013 to May 2014 in Guangdong Women and Children's Hospital and Health In-stitute were reviewed retrospectively. Pathology,the prenatal diagnosis and treatment of bronchogenic cysts experience were summarized combined with CT after birth and surgery. Results Based on the prenatal diagnosis of fetal and postnatal CT and surgical pathology,a total of 7 cases with congenital bronchial cysts were diagnosed. Of which 4 ca-ses were suggestive of congenital cystsic adenomatoid malformation by prenatal diagnosis,and the other 3 cases had fetal bronchial cysts by prenatal diagnosis,antenatal diagnosis was accurate in 42. 9%(3 / 7 cases). CT examinations were taken in 7 cases after birth,and the cyst excision was performed on them with surgery thoracic approach;the average age at surgery was(5. 3 ± 1. 7)months. Four cases had simple bronchial cystss,2 cases with congenital cystsic adenomatoid malformation,1 case with congenital pulmonary sequestration. The accuracy of CT diagnosis was 85. 7%(6 / 7 cases). All surgical treatment was effective. Conclusions Fetal bronchial cysts is always associated with the other presence of lung congenital malformations. Prenatal diagnosis of congenital bronchial cysts is difficult. Prenatal diagnosis is difficult to exclude congenital cystsic adenomatoid malformation. To avoid symptoms like oppres-sion,infection,prenatal diagnosis combined with CT examination after birth and early treatment are necessary and reliable clinically.

Accurate wound assessment and efficient wound data management are critical to wound care. In recent years, the application of intelligent equipment in the field of wound care has improved the accuracy of wound assessment and the efficiency of wound data management. This article reviews the current status of intelligent wound assessment and data management, aiming to provide a new perspective on wound assessment and data management and promote the sustainable development of wound care.

Palliative wound care introduces the concept of palliative care into the field of wound care, but its development is still in its infancy. This article will review the definition, goals, and implementation strategies of palliative wound care, aiming to provide a basis for effectively managing wound-related symptoms at the end of life, preventing wound deterioration or new wound complications, alleviating patient's suffering, promoting patient's comfort and dignity, and improving their quality of life.

Objective:Traffic accidents is one of the most common causes of acute stress disorder (ASD), and it will affect the health of patients.This study aimed to investigate the acute stress symptoms and related factors in traffic accident survivors.Methods:A cross-sectional survey was conducted.The general information questionnaire, Acute Stress Disorders Scale (ASDS), Patient health questionnaire-9 (PHQ-9) and Patient' s Health Questionnaire (PHQ-15) were used to investigate survivors in admission 2-30 days.Results:Fourteen survivors had acute stress symptoms in 63 (22.2％) survivors.Stepwise multiple regression analysis showed that survivors with depression, more serious physical symptoms and whether alone when the accident happened was a common experience accounted for 66.8％ of the survivors' acute stress disorder.Conclusion:This study suggests the detection of acute stress symptoms in traffic accident survivors is higher, and there is a correlation with survivors' depression, physical symptoms, and whether alone when the accident happened.Acute stress symptoms could be screened in time for survivors with depressive and severe somatic symptoms.

Objective To apply quality of control circle ( QCC) to reduce the rate of low back pain (LBP) happened on medical staff. Methods The QCC activity were applied in medical staff with LBP in Orthopedic Department of West China Hospital of Sichuan University. The reasons was analyzed, and the corresponding measurements were made and implemented. The result of activity were evaluated. Results The rate of LBP were decreased significantly from 146 to 92 with a progress rate of 37. 23% and achieved rate106. 17%. This activity standardized the process of low back pain protection. Conclusions QCC activity play a positive role in reducing the rate of low back pain and it definitely can improve the health status of medical staff and their life quality.

Objective To explore the status of knowledge , attitude and practice in enhanced recovery after surgery (ERAS) among surgical medical staff, and analyze its influencing factors, so as to provide basic information for the multidisciplinary training and education program .Methods A self-designed questionnaire was used to survey 640 surgical medical staff of 17 surgical departments such as osteopathic department , gastrointestinal surgery and neurosurgery in West China Hospital of Sichuan province .The questionnaire included three parts: knowledge , attitude and practice .The SPSS 17.0 statistical software was applied for data analysis and processing.Results The score of ERAS knowledge among medical staff was (39.13±14.23). The score of reducing hospitalization time and costs was (3.30±1.30), which was the highest, while the score of anesthesia was (2.47±1.15), which was the lowest.The score of neurosurgery department was the lowest and was (25.35±12.82), while the score of general surgery was the highest and was (46.12±12.83). As for the ERAS attitude and practice of medical staff , 93.91%of medical staff agreed that ERAS could enhance patients′recovery after surgery .99.06%and 98.13%of the medical staff were willing to participate in the related study and research .41.41%of staff recently had access to relevant knowledge within one month.The most important way of acquiring knowledge was communication between colleagues and lectures . Single factor analysis showed that:there were significant difference in ERAS knowledge score among medical staff with different departments, occupation, age, job title, highest education and working experience (P<0.01).Conclusions The ERAS knowledge score of surgical medical staff is low , and their clinical practice doesn′t match their attitude .Departemnts should organize targeted ERAS training according to different characteristics of medical staff among medical staff .The ERAS should be applied into the clinical practice and better the service for patients .