The 80th American Diabetes Association(ADA)Scientific Sessions was held online from June 12 to 16, 2020. There was some hot debates on the topics of diabetes related complications in the annual meeting of ADA. Endocrinologists and cardiologists debated and presented different perspectives. This paper will summarize the debates on the following five topics: (1)Microvascular and macrovascular complications of diabetes are distinct pathophysiologic entities.(2)Guideline recommendations for cardiovascular risk and disease management in type 2 diabetes.(3)Drawing the line between primary and secondary prevention—necessary or too simplistic? (4)Should metformin be considered first-line therapy for individuals with type 2 diabetes with established arteriosclerotic cardiovascular disease(ASCVD)or at high risk for ASCVD? (5)Primary cardiovascular prevention with sodium-glucose co-transporter 2(SGLT2)inhibitors or glucagon-like peptide-1(GLP-1)receptor agonists.

Objective To explore the effect of polypharmacy assessment and intervention on elderly inpatients mainly in both economy and safety. Methods One hundred and forty elderly inpatients were selected. Fifty patients took less than 5 drugs, 75 patients took 5- 9 drugs, and 15 patients took more than 10 drugs. According to medication appropriateness index (MAI) and Beers criteria, the polypharmacy of elderly inpatients was assessed and intervened. The results were compared before and after intervention. Results The discrepancy rate of Beers criteria, incidence of potential risk, total scores of prescription MAI and average daily drug cost after intervention were significantly lower than that before intervention: 7.14% (10/140) vs. 16.43% (23/140), 22.14% (31/140) vs. 90.71%(127/140), 0(0,0)scores vs. 6.00(2.25,10.00)scores and (30.60 ± 19.71) yuan vs. (35.34 ± 26.84) yuan, and there were statistical differences (P<0.01 or <0.05). Conclusions Irregular medication exists widely in elderly patients, and the polypharmacy assessment and intervention can lighten the financial burden of elderly patients and improve the safety of drug therapy.

Objective To develop the scale to measure online intimate relationship and test its validity and reliability for college students.Methods A total of 1 105 subjects were recruited in this investigation for 6 times.Based on literatures,open-ended questionnaire investigations,semi-structured interview and experts' opinions,item analyses,exploratory factor analyses,validity and reliability analysis were conducted to develop the scale.Results The self-made scale showed a second-order structure,including intimacy,passion and commitment dimension.Confirmatory factor analysis showed that the model had good fit (χ2/df=3.47,GFI=0.92,NFI=0.90,CFI=0.92,TLI=0.90,IFI=0.92,RMSEA=0.08).The 3 dimensions had good internal reliability with Cronbach's α coefficients from 0.73 to 0.89 and retest reliability coefficients from 0.80 to 0.91.In addition,the scale had good external validity and convergent validity.ConclusionThe self-made scale has acceptable reliabilities and validities,which can be used to measure online intimate relationship for college students.

Objective To analyze the incidence of invasive fungal infection and the risk factor in primary acute leukemia patients.Methods Retrospectively analysis of clinical data from Jan 2007 to Jun 2008 about 80 newly diagnosed patients with acute leukemia primary treated in Peking University People's hospital.Results The incidence of invasive fungal infection is 13.8%,elderly patients、higer WBC counts and longer antibiotics treatment are the risk factor for the fungal infection.Conclusion There are high incidence of invasive fungal infection in induction therapy for primary acute leukemia,the prophylaxis therapy should be consider in high risk patients.

ObjectiveTo study X-ray and high resolution computed tomograghy(HRCT)features and tIleir relationship with pulmonary function test in pulmonary alveolar proteinosis(PAP).MethodsThe findings of X-ray and HRCT and the Resultsof pulmonary function tests in 19 patients with PAP were reviewed retrospectively.X-ray and HRCT scores were rated in the aspects of opacity density,extent,and severity.The relationship between the imaging scores and pulmonary function tests were determined.ResultsX-ray showed a symmetrical perihilar predominance appearance in patients with PAP.HRCT scan showed bilateral clear-defined pathchy areas of ground-glass opacity and interlobular septal thickening,a pattern commonly characterized as"crazy paving".Nineteen PAP respiratory function Resultswere:DLCO/Pred=(54.49±16.78)%,FEV1/FVC=(86.00±6.70)%.Chest radiographic extent score and severity score correlated with diffusing capacity(r=-0.661,P＜0.01,r=-0.475,P＜0.05).HRCT severity score was 16.47±5.26.Among all the HRCT scores,severity score correlated significantly with the presence of restrictive ventilatory defect and diffusing capacity defect(DLCO/Pred,r=-0.809,P＜0.01;FEV1/FVC,r=0.573,P＜0.05).ConclusionsIn patients with PAP,there Is close relationship between X-ray,HRCT findings and pulmonary function.HRCT correlates more closely with pulmonary function.

Objective:To investigate the feasibility of adipose tissue-derived stem cells(ADSCs) as the seeding cells of skin engineering for skin defect repair. Methods :Adipose tissues were isolated from a SD rat groin, the fat was cut and incubated in a collagenase solution, and then the ADSCs were cultivated in culture medium. The amplified cells in vitro were inoculated in collagen gel to form tissue engineered skin. Fifteen SD rats were randomly divided into three groups: experimental group was treated with ADSCs collagen tissue engineered active skin substitute, and single collagen and blank were served as two control groups. The materials were grafted onto total skin defect wounds on the back of rats in the corresponding group respectively. The effect of wound repair was observed histologically. Results:The time of wound healing in the ADSCs and collagen experimental group, the single collagen control group and the blank control group were (14.3?1.7) days,(16.9?2.5)days,and (21.2?4.2)days respectively, and showed significant differences(P

285 cases of maternal deaths in Xian area from1980～1990 were reported. The average maternalmortality in urban and rural areas were 16. 3/100000 and 73. 8/100000 respectively, a differenceof 4. 5 times. The main cause of maternal deathwas obstetrical hemorrhage (49. 8%), the nextwere pregnacy indced hypertension and cardiac dis-eases. Of the 285 cases,36. 8% had no antenatalcare. In urban areas maternal death occarred all inhospitals, but in the rural areas 39. 2% happenedat home or on the way to hospitals. Positive. sug-gestions were given according to the major influ-ence factors on safe motherhood.

Objective Sphingosine kinase 1 (SPK1) has been identified as a central mediator of ischemia preconditioning, and it has been shown to protect reactive oxygen species (ROS)-induced cardiomyocytes death. The present study aims at investigating the protective effects of adenovirus-mediated sphingosine kinase 1 gene (Ad-SPK1) transfer on ischemia-reperfusion induced cardiac injury. Methods Wistar rats were anesthetized and a left thoracotomy was performed. About 5?108 PFU of Ad-SPK1 in total volume of 100?l was injected intramyocardially into four separate sites of the left ventricular wall with a 30-gauge needle. The control rats received the same injection of adenovirus carrying green fluorescent protein gene (Ad-GFP). Three days later, hearts were isolated and subjected to ischemia/reperfusion (I/R) (30min/30min) ex vivo. Heart performance was evaluated by measuring the left ventricular systolic pressure (LVSP) and left ventricular end-diastolic pressure (LVEDP). The incidence of arrhythmia was recorded. Cardiomyocyte viability was detected by the detection of the release of creatine kinase (CK). The cardiac SPK1 activity was measured using an enzyme method. The forced and the total SKP1 expression was analyzed by immunoblotting with anti-FLAG and anti-SPK1 antibodies. Results The cardiac SPK1 activity was increased by about five-fold by injection of Ad-SPK1, compared to Ad-GFP control group. A more potent performance and a lower incidence of arrhythmia were observed in Ad-SPK1-injected hearts during the reperfusion period, compared with Ad-GFP-injected ones. Enzymatic activity assay showed that creatine kinase release was also less in Ad-SPK1-injected hearts. Conclusion Adenovirus-mediated SPK1 gene transfer efficiently protects heart from injury induced by ischemia-reperfusion.

Objective To investigate the pregnancy outcome of frozen-thawed embryos transfer in different endometrial progesterone preparation time.Methods From January to December 2012,pregnant outcome of 1 103 frozen-thawed embryo transfer cycles using artificial periodic endometrial preparation were studied retrospectively in Reproductive Medical Center of Henan Provincial People's Hospital.It was divided into 4 groups:group 3-3 (n =543,3 days after endometrial progesterone preparation and transfer D3 embryo),group 4-3(n =330,4 days after endometrial progesterone preparation and transfer D3 embryo),group 5-5 (n =150,5 days after endometrial progesterone preparation and transfer D5 blastula),group 6-5 (n =80,6 days after endometrial progesterone preparation and transfer D5 blastula).The rate of implantation,pregnancy,ectopic pregnancy,multiple pregnancy,and first trimester abortion were compared among those groups.Results (1) With the different endometrial progesterone preparation methods and transfer D3 embryos,implantation rate [group 3-3:39.9％ (429/1 074) ; group 4-3:44.1％ (286/648)],pregnancy rate [group 3-3:56.0％ (304/543) ; group 4-3:59.4％ (196/330)],ectopic pregnancy rate [group 3-3:3.3％ (10/304) ; group 4-3:2.6％ (5/196)],multiple pregnancy rate [group 3-3:38.5％ (117/304) ; group 4-3:43.4％ (85/196)]and early abortion rate[group 3-3:13.5％ (41/304); group 4-3:13.3％ (26/196)] had no significant differences between group 3-3 and group 4-3 (all P ＞ 0.05).(2) With the different endometrial progesterone preparation methods and transfer D5 blastocysts,implantation rate [group 5-5:64.7％ (191/295) ; group 6-5:69.4％ (100/144)],pregnancy rate [group 5-5:80.7％ (121/150) ; group 6-5:78.8％ (63/80)],ectopic pregnancy rate [group 5-5:2.5％ (3/121) ; group 6-5:0],multiple pregnancy rate[group 5-5:55.4％ (67/121) ; group 6-5:46.3％ (37/80)] and early abortion rate[group 5-5:5.8％ (7/121); group 6-5:7.9％ (5/63)].However,there were no significantly differences between group 5-5 and group 6-5 (all P ＞ 0.05).Conclusions The two different progesterone transformed endometrial methods can obtain satisfactory clinical outcome with D3 embryo or D5 blastocysts transfor.It is convenient to clinical and laboratory work arrangements.

Objective To investigate the role of indoleamine 2,3-dioxygenase(IDO)in asthma.Methods The mouse asthma model was induced by ovalbumin(OVA).IDO expression was detected on the level of protein and mRNA respectively.Distribution and maturation of dendritic cells were detected by the immunofluorescence method.Results (1)The symptoms and lung inflammation in the model group were more serious than control group.The serum total IgE was significantly higher in the model group than that in the control group,165.50 ± 30.13 ng/ml vs.94.45 ± 28.30 ng/ml(P ＜ 0.05).(2)IDO expression in the model group was lower than that in control group.On the level of protein,mean intergrated optical density was 11.38 ± 6.05 in the model group vs.23.62 ± 8.92 in the control group(P ＜ 0.05);on the level of mRNA,IDO expression of the model group was 33% of the control group(P ＜ 0.05).(3)CD11c+CD86+ cells were distributed in alveolar wall and around small vessels.The quantity of CD11c+CD86+ cells in lungs of the model group were significantly smaller than that in the control group.The median intergrated fluorescence intensity was 9961.86(range,7 406.52 ～ 12 724.98)in the model group vs.15974.60(range,10 006.39 ～ 16 171.46)in the control group(P ＜ 0.05).Conclusions IDO expression is low and matured dendritic cells are less in situ in the asthma model.These suggest that less matured DCs may produce less IDO,which may play an important role in asthma.