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.

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 investigate the clinical characteristics, diagnosis and treatment of mycoplasma pneumoniae(MP) pneumonia in children with pseudo-macrocytic erythrocytes.Methods:The clinical data of 50 children with mycoplasma pneumoniae pneumonia with pseudo-macrocytic erythrocytes in the Department of Pediatrics at Shengjing Hospital of China Medical University from January 2019 to August 2020 were analyzed retrospectively.Results:Among the 50 cases, there were 32 boys and 18 girls.The blood routine examination showed that pseudo-macrocytic erythrocytes, red blood cells decreased significantly, mean corpuscular volume, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration increased significantly, as well as MP-IgM was positive.Sixteen cases were complicated with herpes simplex virus infection, one with Epstein Barr virus infection, and six with both herpes simplex virus and Epstein Barr virus infection at the same time.All 50 cases were MP pneumonia, pulmonary imaging showed lobar pneumonia, and 25 cases were complicated with pleural effusion, including 32 cases of refractory MP pneumonia.The clinical symptoms of three cases were extrapulmonary manifestations, hemolytic anemia and diagnosed with cold agglutinin syndrome.In 36 children with D-dimer more than 252 μg/L, one case had femoral vein thrombosis and one case had pulmonary embolism.Conclusion:Pseudo-macrocytic phenomenon may play important roles in clinical etiological diagnosis, severity of disease and refractory MP pneumonia.The children with hemolytic anemia suggest cold agglutinin syndrome, and the hypercoagulable state of MP infection may be related to the aggregation of red blood cells caused by cold agglutinin in MP infection.

Objective To investigate the effect of asymptomatic hyperuricemia after renal transplantation on renal function of the grafts.Methods The follow-up data were retrospectively collected and analyzed in 144 patients with renal transplantation from January 2010 to March 2015.The patients were classified into three groups according to the level of serum uric acid (SUA):group A (normal group),group B (asymptomatic hyperuricernia with average SUA less than or equal to 360 μmol/L after treatment),and group C (asymptomatic hyperuricemia with average SUA greater than 360μmol/L after treatment).The renal function indexes such as serum creatinine (SCr) and estimated glomerular filtration rate (eGFR) were compared among three groups from 12 to 48 months after transplantation.Results The SCr and eGFR showed no significant difference between group A and group B at 12th month (P＞0.05),but ther are superior than Group Ⅲ (P＜0.05).Conclusion After renal transplantation,asymptomatic hyperuricemia can lead to impaired renal function,and there are no significant differences in renal function between renal transplant recipients with normal SUA levels after treatment and those without hyperuricemia.

Objective:To understand the current situation of mood disorders in patients with thoracic and lumbar osteoporotic fractures and to preliminarily explore its influencing factors.Methods:A cross-sectional survey method was used to select 212 patients with thoracic and lumbar osteoporotic fractures from Department of Orthopedics, West China Hospital, Sichuan University, from January 2018 to September 2020 as the research subjects. The general information questionnaire, Huaxi Emotional-distress Index, Pittsburgh Sleep Quality Index (PSQI) and pain Visual Analogue Scale (VAS) were used to investigate them.Results:The incidence of mood disorders in patients with thoracic and lumbar osteoporotic fractures was 10.38% (22/212). The results of multivariate regression analysis showed that age, days of injury, PSQI score and pain VAS score were the influencing factors of emotional disturbance in patients with thoracic and lumbar osteoporotic fractures ( t values were -3.72-7.66, all P<0.05). Conclusions:Patients with thoracic and lumbar osteoporotic fractures have mood disorders. Age, injury days, PSQI score and VAS score are related to the occurrence of mood disorders in patients with thoracic and lumbar osteoporotic fractures. More attention should be payed to the influencing factors of mood disorders in patients,and timely measures should be taken for individualized intervention.

ObjectiveTo investigate the virologic response to direct-acting antiviral (DAA) therapy and the changes in liver stiffness measurement (LSM), fibrosis-4 (FIB-4), and aspartate aminotransferase-to-platelet ratio index (APRI) after treatment in chronic hepatitis C (CHC) patients with different alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels at baseline in a real-world setting. MethodsCHC patients who attended the outpatient service of Department of Infectious Diseases, Peking University First Hospital, from December 2017 to May 2020 were enrolled, and virologic response rate was calculated. The Wilcoxon rank-sum test was used to compare LSM, FIB-4, and APRI between groups at baseline and at 12 weeks after treatment, and the chi-square test was used for comparison of categorical data between groups. ResultsA total of 48 CHC patients were enrolled, among whom 33.3% had abnormal ALT or AST at baseline. Among these patients, the virologic response rate was 85.4% at week 4 of treatment and 100% at the end of treatment and at 12, 24, and 48 weeks after treatment, and there were significant changes from baseline to 12 weeks after treatment in LSM ［6.1 (51-12.4) kPa vs 8.6 (5.7-16.9) kPa, Z=-1.676, P=0.043］ and APRI ［0.24(0.19-0.48) vs 0.42(0.23-1.17), Z=-2.050, P=0027］. From baseline to 12 weeks after treatment, the patients with abnormal ALT or AST at baseline had significant changes in LSM ［89(5.6-13.1) kPa vs 14.4(8.0-28.2) kPa, Z=-1.679, P=0.047］ and APRI ［0.44(0.25-0.50) vs 1.29(0.99-2.09), Z=-3.427, P=0.001］. ConclusionCHC patients achieve a high sustained virologic response rate after DAA therapy, and the patients with abnormal ALT or AST at baseline tend to have more significant improvements in LSM and APRI than those without such abnormality.