Objective To demonstrate the influence of PCT concentration and its descent to the prognosis of patients with hospital acquired bacterial pneumonia. Methods The PCT concentration was determined. One hundred and thirteen HAP patients were enrolled from September 2011 and November 2012 , including 64 patients in the non-survival group and 49 patients in the survival group , and 92 non-infected patients in the control group. The relationship between PCT and hospital days and survival rate was analyzed. Results The initial value of PCT in the non-survival group and in the survival group were higher than that in the control group, while the PCT in the non-survival group was the highest, with significant difference (P =0.0002). Taking PCT = 0.78 μg/L as the cut-off value, the sensitivity and specificity to predict the mortality of the HAP patients was 0.66 and 70%, respectively. A significant negative correlation was shown between PCT value and hospital days in the non-survival group. The survival rate of patients with PCT decrease over 50% was higher than that of patients with PCT decrease less than 50% after treatment. Conclusion Dynamic monitoring PCT in patients with bacterial HAP possesses a certain significance.

Objective To investigate the relationship between serum leptin and carotid intima-media thickness in patients with type 2 diabetes mellitus. Methods 35 patients with type 2 diabetes mellitus (DM) and 16 normal controls were studied. Fasting serum leptin, fasting glucose(FBG), HbAlc, C-peptide, lipide, systolic(SBP), diastolic blood pressure(DBP), body mass index (BMI) and waist circ-umference (WC) were measured in all subjects. The intima-media thickness (IMT) of common carotid artery was measured by high-resolu-tion ultrasound imaging. Results IMT of T2DM was positively correlated with leptin concentration. Conclusion Serum leptin concentra-tion is independently associated with the IMT of carotid artery, which suggest that leptin may be an independent risk factor of atherosclerosis.

Objective To explore the association of serum high-sensitivity C reactive protein (hs-CRP) level with leptin in patients with type 2 diabetes mellitns (T2DM). Methods 35 cases of T2DM patients were involved in the study and 16 normal subjects were taken as controls. Fasting serum leptin and CRP were measured .The relationship between them were also analyzed. Results Fasting serum hs-CRP concentration in T2DM group was higher than that in healthy control group, but serum ieptin levels is the same (P > 0.05). Partial correlation analysis demonstrated that fasting hs-CRP level was positively correlated with leptin (r =0.512 ,P =0. 018). Conclusion Fasting serum hs-CRP level is significantly raised in T2DM ,which is associated with leptin. There is chronic inflammatory reaction in T2DM patients,and leptin is possibly involved in inflammatory pathogenesis of T2DM.

Objective Treatment of type 1 diabetes mellitus has always posed a challenge to balance hyperglycemia control with hypoglycemia episodes. This review attempts to outline the application and research progress of real?time continuous glucose monitoring technology.Given the evolution of RT?CGM technologies,it is likely that today’ s more accurate RT?CGM systems will result in improved patient trust and reduced alert fa?tigue,translating into more sustained RT?CGM use,greater use of the RT?CGM data,and better outcomes.

Objective To explore the expression and clinical value of serum calprotectin and toll like receptor 2(TLR2)with type 2 diabetic kidney disease(DKD).Method According to the levels of UACR,90 T2DM patients treated in our hospital from January 2019 to January 2022 were divided into normal albuminuria group(Con,UACR<30 mg/g),microalbuminuria group(Micro,UACR 30～300 mg/g),and macroalbuminuria group(Macro,UACR>300 mg/g),30 cases per group.Result The levels of BMI,HbAlc,calprotectin,TLR2,and NLRP3 increased sequentially from Con,Micro to Macro groups(P<0.05),while eGFR in the Macro group was lower than that in the Con or Micro groups(P<0.05).Pearson correlation analysis showed that serum calprotectin was positively correlated with BMI,WC,SBP,FPG,HbAlc,TC,TG,Scr,UACR(P<0.05 or P<0.01),and negatively correlated with eGFR(P<0.01);NLRP3 is positively correlated with BMI,WC,SBP,FPG,HbAlc,TC,TG,Scr,SUA,and UACR(P<0.01),and negatively correlated with eGFR(P<0.01);TLR2 was positively correlated with BMI,WC,SBP,FPG,HbAlc,TC,TG,Scr and UACR(P<0.05 or P<0.01),and negatively correlated with eGFR(P<0.01).Multiple linear regression analysis showed that FPG,HbAlc,TC,Scr,calprotectin,and TLR2 were the influencing factors of UACR.Receiver operating characteristic(ROC)curve analysis showed that the area under the curve for diagnosing DKD with serum calprotectin and TLR2 was 0.883 and 0.961,with sensitivities of 73.33%and 96.67%,and specificity of 100.00%and 83.33%.Conclusion Serum calprotectin and TLR2 are closely related to the occurrence and development of DKD.The diagnostic value of TLR2 for DKD is superior to serum calprotectin.

Objective:To study the current status of longitudinal extrauterine growth restriction (EUGR) in extremely preterm infants (EPIs) and to develop a prediction model based on clinical data from multiple NICUs.Methods:From January 2017 to December 2018, EPIs admitted to 32 NICUs in North China were retrospectively studied. Their general conditions, nutritional support, complications during hospitalization and weight changes were reviewed. Weight loss between birth and discharge > 1SD was defined as longitudinal EUGR. The EPIs were assigned into longitudinal EUGR group and non-EUGR group and their nutritional support and weight changes were compared. The EPIs were randomly assigned into the training dataset and the validation dataset with a ratio of 7∶3. Univariate Cox regression analysis and multiple regression analysis were used in the training dataset to select the independent predictive factors. The best-fitting Nomogram model predicting longitudinal EUGR was established based on Akaike Information Criterion. The model was evaluated for discrimination efficacy, calibration and clinical decision curve analysis.Results:A total of 436 EPIs were included in this study, with a mean gestational age of (26.9±0.9) weeks and a birth weight of (989±171) g. The incidence of longitudinal EUGR was 82.3%(359/436). Seven variables (birth weight Z-score, weight loss, weight growth velocity, the proportion of breast milk ≥75% within 3 d before discharge, invasive mechanical ventilation ≥7 d, maternal antenatal corticosteroids use and bronchopulmonary dysplasia) were selected to establish the prediction model. The area under the receiver operating characteristic curve of the training dataset and the validation dataset were 0.870 (95% CI 0.820-0.920) and 0.879 (95% CI 0.815-0.942), suggesting good discrimination efficacy. The calibration curve indicated a good fit of the model ( P>0.05). The decision curve analysis showed positive net benefits at all thresholds. Conclusions:Currently, EPIs have a high incidence of longitudinal EUGR. The prediction model is helpful for early identification and intervention for EPIs with higher risks of longitudinal EUGR. It is necessary to expand the sample size and conduct prospective studies to optimize and validate the prediction model in the future.

[Objective] To investigate the functional differences and potential effects of chromatin spatial structure in patients with normal karyotype and complex karyotype multiple myeloma. [Methods] High-throughput chromosome conformational capture (Hi-C) analysis was performed on plasma cells of 1 case with 1q21 complex karyotype and 1 case with normal karyotype multiple myeloma, and the differences in three-dimensional genome structure between the two patients were analyzed, and the transcriptome characteristics of plasma cells were combined to investigate the differential features through gene functional enrichment. [Results] A/B switch occurred in 36% of the chromatin compartments in two cases, and 1 041 genes in patient with complex karyotype had B/A switch. About 3 500 topological association domains (TADs) were identified in each sample, and there was no significant difference. The number of loops identified in complex karyotype sample was 1 069, which was 1/6 of the normal sample, and there were significant differences in the number of three different types of loops, which to some extent reflected the loss of genome stability. Transcriptome analysis showed significant differences in expression profiles between the two patients, and a total of 6 150 differentially expressed genes (3 303 up-regulated genes and 2 847 down-regulated genes) were identified. [Conclusion] Compared with patient with normal karyotype, patient with 1q21 complex karyotype multiple myeloma exhibit significant changes in the spatial structure of plasma cell chromatin at different levels, which leads to changes in gene expression and activation of pathways related to cancer progression.