Although Addison's disease is uncommon, it may contribute to maternal and fetal morbidity and mortality if not treated appropriately. Clinical features, laboratory tests and endocrine function tests which conduce to diagnosis are reviewed. The long-term corticosteroid replacement therapy plays an important role in the treatment. Close monitoring during labor and postpartum, appropriate arrangement of corticosteroid could optimize the maternal and fetal outcome.

Objective To investigate the prevalence and risk factors of metabolic syndrome (MS) in patients with type 2 diabetes in special care unit.Methods Two thousand three hunrded and sixty patients with type 2 diabetes were selected as our subject in The Sixth People's Hospital Affiliated to Shanghai Jiaotong University from Jan.2010 to Jul.2012.Among these patients,462 patients from special care unit were served as special care group and 1 898 patients from endocrinology ward were assigned to control group.The disease history information was recorded and physical examination and biochemical tests,including blood lipids,blood pressure,fasting glucose,glycosylated hemoglobin,serum insulin,C peptide were measured.Results (1) In special care group,there were 335 male (72.5％) and the prevalence of smoking,alcohol drinking and the proportion of the high income people were 40.5％,24.9％,76.6％ respectively,higher than that of control group (56.6％,24.6％,10.7％,12.7％ ;x2 =32.1,16.9,12.3,32.8 ;P ＜ 0.01).The body mess index (BMI),levels of waist circumference,alanine aminotransferase (ALT),gamma glutamyhransferase (γ-GT),triglyceride (TG),serum uric acid and fasting C peptide in special care group were ((25.6 ± 3.7) kg/m2,(91.0 ± 9.5) cm,(27.8 ±19.7) U/L,(34.1 ±26.3) U/L,(2.35 ±2.31) mmol/L,(333.7 ±85.5) μmol/L,(2.11 ±1.04) μg/L) higher than those of control group ((24.8 ± 3.5) kg/m2,(89.1 ± 10.3) cm,(23.0 ± 16.1) U/L,(29.2 ±23.2) U/L,(1.82 ±1.64) mmol/L,(317.1 ±85.2) μ mol/L,(1.74 ± 1.05) μg/L;F =11.44,6.90,16.65,8.35,18.23,7.34,21.21 ; P ＜ 0.01).The age,duration of diabetes,systolic blood pressure,level of serum high-density lipoprotein-cholesterol (HDL-C),and glycosylated hemoglobin were ((52.9 ± 11.1) years,5 (2,10) years,(126.7 ± 15.2) mmHg,(1.02 ± 0.32) mmol/L,(8.44 ± 1.99) ％) lower than those of control group((60.4 ± 12.2) years,7 (2,12) years,(131.9 ± 17.3) mmHg,(1.10 ± 0.32) mmol/L,(9.16 ±2.32)％;F =79.41,12.71,18.93,12.78,18.52; P ＜ 0.01); (2) The rate of overweight/obesity,dyslipidemia and MS prevalence rates in special care group were 55.6％,68.4％,60.2％,significantly higher than the control group(46.1％,52.9％,50.6％ ;x2 =7.59,18.76,7.18,P ＜ 0.01).While the prevalence of hypertension in special care group was significantly lower than control group(39.6％ vs 50.7％,x2 =10.15,P =0.01).There was on significant difference between male and female in term of the prevalence of the MS in the special care group(61.2％ vs 57.5％,x2 =0.01,P =0.92).According to age,patients in special care group were divided into three groups and that were ＜45 years group,45-59 years group and ≥60 years group.With the increase of age group of female,the prevalence of MS was increasing(33.3％,48.0％,74.1％ ;x2 =4.43,P =0.04).Among the male patients,there was no significant different was seen among three groups (58.8％,62.5％,55.6％ ;x2 =0.05,P =0.87).(3) Multiple Logistic regression analysis showed that the independent risk factors of MS in special care group including age(OR =1.071,95％ CI(1.027-1.117),P =0.01),BMI (OR =1.391,95％ CI(1.112-1.739) ; P =0.013),waist circumference (OR =1.126,95％ CI(1.039-1.222) ; P =0.004),TG (OR =1.747,95 ％ CI(1.124-2.717) ; P =0.013) and diastolic blood pressure (OR =1.111,95％CI(1.045-1.180);P =0.001).HDL-C(OR=0.048,95％CI(0.005-0.464) ;P =0.009) were protective factors of MS in special care group.Conclusion Approximately 3/5 patients with diabetes in special care unit got MS.The factors including age,BMI,waist circumference,diastolic blood pressure,TG,HDL-C were related to MS occurrence.

Objective To explore the clinical significance of expression of soluble mesothelin relatedprotein(SMRP)and carbo-hydrate antigen (CA125)in the serum and tumor tissues of the patients with ovarian cancer.Methods The preoperative and post-operative levels of SMRP and CA125 in serum and ovarian cancer tissues were detected in 82 patients with ovarian cancer (group A),76 cases of benign ovarian tumor (group B)and 53 healthy women (group C)by using ELISA and the immunohistochemical method respectively.Serum levels of SMRP and CA125 in the ovarian cancer patients were measured after one year by ELISA.The correlation among the various statistical indexes was analyzed.Results The positive expression rates of SMRP and CA125 in the group A were significantly higher than those in the group B(P <0.05);compared with the group B and C,the preoperative serum level of CA125 and SMRP in the group A was significantly increased (P <0.001);the preoperative serum CA 125 level in the group B was higher than that in the group C;compared with the stage Ⅰ and Ⅱ,the serum CA125 and SMRP in the stage Ⅲ and Ⅳ of o-varian cancer were significantly increased(P <0.05 );compared with before operation,the postoperative SMRP and CA125 levels were significantly decreased(P <0.05).After 1 year of discharge from hospital,compared with the basically stable patients,serum CA125 and SMRP levels in the patients with ovarian cancer recurrence were significantly increased(P <0.05).The sensitivity and specificity for diagnosing ovarian cancer,any single detection was inferior to the combination detection of CA125 and SMRP.Conclu-sion The combination detection of CA125 and SMRP has an important value for increasing the sensitivity and specificity of ovarian cancer diagnosis,early diagnosis,illness condition monitoring and effect evaluation.

Objective To analyze the risk factors of retinopathy and nephropathy in hospitalized patients with type 2 diabetics. Methods 24 h-urinary albumin was measured in 2 338 patients with type 2 diabetic hospitalized from July, 2002 to Sep, 2008 in our hospital. All the subjects were divided into normalbuminuria group (NA) and diabetic nephropathy group (DN), the latter consisted of microalbuminuria group (MAU) and macroalbuminuria group (CAU). All the patients were divided into normal retina group (NR) and diabetic retinopathy group (DR), the latter consisted of background diabetic retinopathy group (BDR) and proliferative diabetic retinopathy group (PDR) according to fundus photography. Results (1) The percentages of DR and DN of this cohort were 28.8% and 28.7%, respectively.The percentage of DR and DN had no statistical difference between male and female (27.8% vs 30.0%;29.6% vs 27.6%, P>0.05). (2) The percentage of DR was 23.1%, 37.7% and 56.6% in NA, MAU and CAU group, respectively. There was significant difference among different albuminuria group (P<0.01). (3) The percentage of DN was 23.1%, 41.1% and 59.3% in NR, BDR and PDR group, respectively. There was significant difference among different DR group (P<0.01). (4) Combined with DN, diabetes duration, systolic pressure, hemoglobin A1C, triglyceride were independently associated with DR by Logistic regression analysis. Meanwhile, combined with DR, systolic pressure, hemoglobin A1C, and triglyceride were all independently associated with DN. Conclusions The onset and progression of microvascular complications in type 2 diabetic patiens are correlated with hemoglobin A1C and systolic pressure. Diabetic retinopathy is closely correlated with diabetic nephropathy.

Although type 2 diabetes is a disease often associated with aging, the global prevalence of early-onset diabetes has been increasing due to man's sedentary lifestyle, low-physical activity, obesity, and some nonmodifiable risk factors. Many studies have found that individuals with early-onset type 2 diabetes were at higher risk of developing vascular complications than those with late-onset diabetes. Individuals with early-onset diabetes are usually unwilling to visit hospital and have more confidence in their health, which results in poor glycemic control and the delayed detection of diabetes-related complications. Few studies have focused on the treatment and prevention of complications in specific population of individuals with early-onset type 2 diabetes. Therefore, focusing on this particular population is critical for the government and academic societies. Screening for T2DM is imminent for young adults with a family history of diabetes, obesity, markers of insulin resistance, or alcohol consumption. More data are definitely required to establish a reasonable risk model to screen for early-onset diabetes.
Age of Onset ; Alcohol Drinking ; Cardiovascular Diseases ; epidemiology ; etiology ; China ; epidemiology ; Comorbidity ; Diabetes Complications ; prevention & control ; Diabetes Mellitus, Type 2 ; complications ; epidemiology ; therapy ; Humans ; Insulin Resistance ; Obesity ; complications ; epidemiology ; Randomized Controlled Trials as Topic ; Risk Factors