To exclude the interfering factors in islet cell antibodies(ICA) determination some pretreatments on both pancreatic sections and serum samples were made. The results revealed that the islet structures of pretreated pancreatic frozen section appeared clearly. The positive rate of ICA by ABC enzyme-labelled method was higher than that by indirect immunofluorescence method. Comparing the ICA results of exchange sera provided by Immunology and Diabetes Workshop with the reference results,the validity、consistency、sensitivity and specificity was 81%、63%、75%and 88%, respectively. These results suggest that ABC method with the pretreated pancreatic frozen section is a stable method of ICA determination.

Objective To reveal the incidence and types of acid-base disorder (ABD) of critically ill patients in emergency.Methods The clinical data of critically ill patients in the resuscitation room were collected prospectively from December 1,2008 to March 31,2009.Both arterial and venous blood samples were collected to detect arterial blood gas analysis and serum electrolytes simultaneously and their ABD were analyzed.Results Of totally 766 cases,the incidence of ABD was 97.3％ (745 cases).Among ABD the simple acid-base disorder ( SA BD) was 149 cases ( 20.0％ ),dual acid-base disorder (DABD) 525 (70.5％ ) and triple acid-base disorder (TABD) 71 (9.5％ ).After calculating anion gap (AG),the incidence of TABD increased from 12 to 71 cases and the missed diagnosis rate were 83.1％ (59 cases) and after calculating potential HCO3-,the incidence of TABD increased from 8 to 71 cases and the missed diagnosis rate were 88.7％ (63 cases).The age of patients with TABD (77.9 ± 10.7 years old) was older ( P ＜ 0.01 ) than that of other two groups of SABD and DABD as well as APACHEⅡ score (25.9 ± 7.1 ) and incidence (22.5％ ) of MODS in TABD were higher (P ＜0.01 ).The mortality of patients with TABD on the first,second,third and seven day were 14.1％,23.9％,26.8％ and 38.0％ respectively and significantly higher than those in SABD and DABD (P ＜0.05 or P ＜0.01 ).Conclusions The incidence of ABD was 97.3％.Calculation of AG and potential HCO3- would help find metabolic acidosis and TABD.The age and APACHEⅡ score were key factors to poor prognosis of patients with TABD.

Objective To analyze the clinical manifestations and treatment of acquired syphilis in children.Methods A retrospective analysis was conducted.The clinical data on 14 patients with acquired syphilis collected from July 2007 to December 2010 were assessed.Results Among the 14 cases,10 were secondary syphilis,2 early latent syphilis,and 2 late latent syphilis.Seven of the patients had been misdiagnosed as other diseases.All the patients had a history of close contact with syphilis patients or having mouth-to-mouth feeding history after chewing food by adult patients with syphilis.Both rapid plasma reagin (RPR) test and Treponema pallidum haemagglutination assay (TPHA) were positive in all the patients.The skin lesions were mainly located in the oral cavity mucosa and rarely in the trunk,which included leukoplakia,mucosal wet papules,and pustules.Conclusions Acquired syphilis in children is often clinically misdiagnosed or ignored.For children presenting with atypical skin rashes,especially for those having close contact with active syphilis patients,acquired syphilis should be suspected.

Objective To analyze the phenotypes of lymphocytes in cerebrospinal fluid derived from the patients with neurosyphilis. Methods Samples of cerebrospinal fluid from 12 patients with neurosyphilis and 20 patients with latent syphilis were collected and analyzed by flow cytometry for CD4 and CD25 expression. Results There was a significant increase in the number of white blood cells in the cerebrospinal fluid of patients with neurosyphilis. FACS analysis showed that most leukocytes were lymphocytes predominated with CD4 + T cells in neurosyphilis patients which were almost 4 times more than that in latent syphilis. However, there was a significant decrease in the proportion of CD4+ CD25high regulatory T cells (Tr) in neurosyphilis patients compared with that in latent syphilis patients. Conclusion A dramatic increase in CD4+ T cell frequency suggested its pathogenic role in neurosyphilis, whereas a decrease in CD25high Tr frequency indicated that CD4 + CD25high Tr cells might play an important role in immune homeostasis of central nervous system.

Objective To assess the clinical presentations and treatment of neurosyphilis with mania as the first manifestation. Methods A retrospective study was performed. Clinical data on neurosyphilis patients with mania as the first manifestation collected from July 2009 to June 2010 were analyzed. Results Twenty cases of neurosyphilis were included in this study, which were all misdiagnosed as schizophrenia, anxiety,cerebral infarction, etc. All the patients had manic symptoms at onset, such as irritability, bad temper, impulsive behavior, disturbance in thinking, and so on. Some patients also suffered from a marked decrease in memory, calculation and cognitive ability. Rapid plasma reagin (RPR) test, Treponema pallidum hemagglutination (TPHA)test and cerebrospinal fluid (CSF) venereal disease research laboratory (VDRL) test were positive in all the patients. Varying degrees of symptomatic improvement was achieved after anti-syphilis and anti-psychotic treatment. CSF was retested in 13 patients 3 months after the end of treatment, and CSF VDRL titer decreased in 10 patients, remained unchanged in 2 patients, and turned negative in 1 patient. Conclusions Neurosyphilis lacks distinctive clinical characteristics. For patients with poor response to conventional antipsychotic therapy,neurosyphilis should be considered, and serology and cerebrospinal fluid tests for syphilis are warranted.

Objective To understand the clinical practice behavior and definite the role function of subspeciality nurses in department of gynaecology and obstetrics.Methods A total of 17 nurse specialisms in department of gynaecology and obstetrics were selected by purposive sampling with the method of field research. Participant observation was used in their clinical nursing activities. And then, field note were recorded timely. Besides, the data was sorted out and analyzed again and again.Results A total of six clinical practice behavior of subspeciality nurses in department of gynaecology and obstetrics were refined including specialty evaluation, professional skills, health education, psychological instruction, continuity management, and teaching and research.Conclusions The rudiment of mode of clinical practice of subspeciality nurses in department of gynaecology and obstetrics firstly appears at the present stage. It still needs to refer the mode of management and cultivation of nurse specialism abroad, improve the the clinical practice behavior and specialist team building of subspeciality nurses in department of gynaecology and obstetrics.

Objective: To investigate the current status of milk tea consumption and its association with psychological distress among college students, so as to provide theoretial support for promoting the mental health of college students. Methods: From September to November 2023, a convenience sampling method was used to select 15 440 college students aged 17-24 from seven universities in Shanghai, Jiangxi, Hubei, and Shanxi. A self designed questionnaire and the Kessler Psychological Distress Scale were used to assess milk tea consumption and psychological distress, respectively. The Mantel-Haenszel test was employed to analyze the trend of psychological distress at different levels of milk tea consumption. Binary Logistic regression analysis was used to determine the association between milk tea consumption and psychological distress, and the restricted cubic spline method was applied to explore the nonlinear relationship between milk tea consumption and symptoms of psychological distress. Results: The detection rate of psychological distress among college students was 59.6%. Univariate analysis indicated a significant trend association between milk tea consumption frequency ( χ 2 trend =42.33) and milk tea intake level ( χ 2 trend = 5.17 ) with psychological distress ( P <0.05). Binary Logistic regression models showed a positive association between different levels of milk tea consumption frequency and psychological distress [1-3 times (mild to moderate distress, OR =1.20,1.41), 4-5 times (mild to severe distress, OR =2.80,5.44,4.12), and ≥6 times (severe distress, OR =8.04); and milk tea intake level: 1-1 500 mL (severe distress, OR =1.35), >1 500- <3 000 mL (mild to moderate distress, OR =1.21, 1.35), ≥3 000 mL (mild to severe distress, OR =1.33,1.71,1.29)] ( P <0.05 ). The restricted cubic spline model showed a nonlinear association between milk tea intake and the risk of psychological distress ( F = 107.34 , P non linear <0.01, P overall <0.01). Conclusions High frequency and high volume milk tea consumption are associated with an increased risk of psychological distress among college students. Reducing the consumption behavior of college students milk tea is helpful to improve mental health.

Objective: To investigate the association between consumption of milk tea beverages and other sugary beverages with insomnia symptoms among college students, so as to the provide reference for promoting sleep quality among college students. Methods: From September to November 2023, a convenience sampling method was used to select 15 440 college students from seven universities in Shanghai, Jiangxi Province, Hubei Province, and Shanxi Province. A self developed questionnaire and the Insomnia Severity Index were used to assess milk tea beverage consumption, other sugary beverages and insomnia symptoms. Univariate analysis of insomnia symptoms among college students was performed using Chi square tests and Cochran-Armitage trend χ 2 tests. Multivariate Logistic regression analysis was conducted for the association between milk tea and other sugary beverage consumption with insomnia symptoms. Results: The detection rates of insomnia symptoms among college students was 40.83%. The frequency of consumption of different milk tea and various sugary drinks (juice, tea, milk, sodas,yogurt, functional drinks, coffee) per week was related to the detection trend rate of insomnia symptoms of college students ( χ 2 trend =38.38, 47.66, 74.16, 32.44, 65.78 , 38.71, 35.94, 91.59, P < 0.01 ). Multivariate analysis indicated that compared to individuals with no milk tea consumption, college students engaging in milk tea consumption had a significantly increased risk of insomnia symptoms ( OR =1.24, P <0.05). Students consuming milk tea at low to moderate frequencies (1-3, 4-5 times per week) showed a higher risk of insomnia symptoms compared to those with no consumption ( OR =1.20, 1.54, P <0.05). Furthermore, higher levels of milk tea consumption were significantly associated with insomnia symptoms (1 501-2 999 mL, OR =1.22; ≥3 000 mL, OR =1.36), and the consumption of other sugary beverages were also associated with insomnia symptoms of college students ( OR =1.10-1.55) ( P <0.05). Conclusions There is a relationship between consumption of milk tea beverage other sugary beverages with insomnia symptoms among college students. Colleges should regularly conduct dietary health education seminars to improve sleep quality among college students.

Objective:To explore the feasibility of early oral nutrition for gastric cancer patients after total gastrectomy based on propensity score matching.Methods:Using convenience sampling method, a retrospective analysis was conducted on the medical records of 755 patients who underwent total gastrectomy for gastric cancer at Jiangsu Subei People's Hospital from 2012 to 2020. A total of 454 patients who received early oral nutrition after surgery were included in the study group, while 301 patients who received conventional nutrition were included in the control group. The study group patients began eating orally on the first day after surgery, while the control group patients began eating orally after anal exhaust. The propensity score matching method was used to balance confounding factors between two groups.Results:A total of 203 pairs (406 cases) of patients were matched. After matching, there was no statistically significant difference in general data between the two groups ( P>0.05). The study group had lower dietary intake time, first anal exhaust time, hospital stay, incidence of abdominal infection, and incidence of anastomotic fistula compared to the control group, with statistically significant differences ( P<0.05) . Conclusions:Early oral nutrition for gastric cancer patients after total gastrectomy can promote intestinal function recovery, shorten hospital stay, and do not increase the risk of complications, including anastomotic fistula. It has the same acceptable tolerance as conventional nutrition, indicating that early oral nutrition after total gastrectomy is safe and feasible.

Purpose: Anterior gradient 3 (AGR3) belongs to human anterior gradient (AGR) family. The function of AGR3 on cancer remains unknown. This research aimed to investigate if AGR3 had prognostic values in invasive ductal carcinoma (IDC) of breast cancer and could promote tumor progression. Materials and Methods: AGR3 expression was detected in breast benign lesions, ductal carcinoma in situ and IDC by immunohistochemistry analysis. AGR3’s correlations with clinicopathological features and prognosis of IDC patients were analyzed. By cell function experiments, collagen gel droplet-embedded culture drug sensitivity test and cytotoxic analysis, AGR3’s impacts on proliferation, invasion ability, and chemotherapeutic drug sensitivity of breast cancer cells were also detected. Results: AGR3 was up-regulated in luminal subtype of histological grade I-II of IDC patients and positively correlated with high risks of recurrence and distant metastasis. AGR3 high expression could lead to bone or liver metastasis and predict poor prognosis of luminal B. In cell lines, AGR3 could promote proliferation and invasion ability of breast cancer cells which were consistent with clinical analysis. Besides, AGR3 could indicate poor prognosis of breast cancer patients treated with taxane but a favorable prognosis with 5-fluoropyrimidines. And breast cancer cells with AGR3 high expression were resistant to taxane but sensitive to 5-fluoropyrimidines. Conclusion AGR3 might be a potential prognostic indicator in luminal B subtype of IDC patients of histological grade I-II. And patients with AGR3 high expression should be treated with chemotherapy regimens consisting of 5-fluoropyrimidines but no taxane.