Objective To determine the associations of visceral adipose tissue area and retinol binding protein 4(RBP4) with bone mineral density (BMD) in the postmenopausal patients with type 2 diabetes mellitus (T2DM).Methods The cross-sectional study involved 69 postmenopausal patients with T2DM (aged 40-73 years) in our hospital,they were divided into 4 groups:group 1:BMI ＜26.0 kg/m2,VAT＜ 155.3 cm2 ; group 2:BMI ＜ 26.0 kg/m2,VAT＞ 155.3 cm2 ; group 3:BMI ＜26.0 kg/m2,VAT＜155.3 cm2;group 4:BMI＜26.0 kg/m2,VAT＞155.3 cm2.The visceral adipose tissue (VAT) area and subcutaneous adipose tissue (SAT) area were obtained by computed tomography(CT) and BMD was measured by dual energy X-ray absorptiometry (DEXA).Results VAT area had negative associanons with lumbar spine BMD (LS-BMD) and greater trochanter BMD (GT-BMD) (r=-0.367,r=-0.301),and with LS-BMD,GT-BMD,femoral neck BMD (FN-BMD) and intertrochanter BMD (IT-BMD) even after adjusting for body mass index(BMI) and SAT (r =-0.433,-0.432,-0.300,-0.297,all P＜0.05).A negative relationship was showed between LNRBP4 and LS-BMD in postmenopausal female patients (all P ＜ 0.05.) The postmenopausal female patients with T2DM were divided into four groups according to the mean values of BMI and VAT area.BMD at any site of group 3(LS-BMD:1.00±0.20,FN-BMD:0.82±0.17,IT-BMD:1.13±0.21,GT-BMD:0.76±0.18) were higher than group 2(0.79±0.14,0.70±0.10,0.95±0.14,0.58±0.11).The multiple regression indicated that the variation of predictors (age,DUR,BMI,VAT,HbA1c,FINS and PMT) explained 51.7％,52.2％,59.8％ and 75.3％ of the variation in LS-BMD.FN-BMD,IT-BMD,GT-BMD among subjects,respectively(all P＜0.01).Conclusions The influence of fat on bone density may depend on its site of VAT or SAT.VAT could be an independent determinant factor of BMDin the postmenopausal female with T2DM.Serum RBP4 may contribute to this effect.

With the development of health care, the use of modern medical devices and the improvement of hospital manage-ment system, Intensive care unit( ICU) emerges.ICU is a treatment-nursing ward, which is a collection of modern medical care tech-nology.With ICU information constructive practice of Nanjing General Hospital of Nanjing Military Region as the background, this pa-per introduces the target base、functional requirements、business processes of the intensive care information system management mode of operation from the perspective of clinical application.Furthermore, this paper describes the realization of the function of the mode of operation with cases as evidence.

Objective To investigate micro-inflammatory state and protein-energy wasting (PEW) states in maintenance peritoneal dialysis(MPD) patients,then analysis of the correlation between them.Methods Ninty-six cases of MPD patients in this Hospital were selected from March 2012 to September 2015.The status of nutrition were assessed by Quantitative Subjective and global Assessment(SGA),malnutrition-inflammation score(MIS) and albumin(Alb),micro-inflammatory state was assessed by enzyme-linked immunoassay(ELISA) method serum hypersensitive c-reactive protein (hs-CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6).At the same time,various serological markers like serum Alb,serum total protein(TP),serum prealbumin(PA),hemoglobin(Hb),transferrin(TF),serum creatinine(Scr),urea nitrogen(BUN),cholesterol(Teh) were measured.Results The incidence of PEW in MPD patients was 36.50％,among which 62.86 ％ of them were over 65 years old,57.10％ were over 2 years of dialysis time and 40.00％ with diabetic nephropathy.MPD patients with hs-CRP＞5 mg/L accounted for 58.33％,of which over 65 year old accounted for 42.86％,MPD age longer than 2 years accounted for 60.71％,32.14％ of them with diabetic nephropathy.The proportion of diabetic nephropathy,average age,dialysis duration time,hs-CRP,TNF-α and IL-6 in PEW group were higher than non-PEW group(P＜0.05);BM,TP,Alb,PA,Hb,TCh,MAC and MAMC were lower ban non-PEW group(P＜0.05).Compared with the hs-CRP≤5 mg/L group,average age,the time of dialysis duration,TNF-α,IL-6 were higher and TP,Alb,PA,TF,Hb,the proportion of Kt/V≥1.72 were lower in the hs-CRP＞5 mg/L group.After the correction of age,sex,dialysis ages,it was found that the level of hs-CRP in MPD patients was negatively correlated with the level of Alb,PA,TF,Tch,Scr,TG;The level of IL-6 was negatively correlated with the levels of Alb,PA,TF,Tch,TG.The level of TNF-α in MPD patients showed different degrees of negative correlation with the leves of Alb,PA,TF,TG,Tch(all P＜0.05).Multivariate analysis showed that elderly,the time of dialysis duration,the microinflammatory state,and hypoalbuminemia were the independent risk factors of PEW.Conclusion PEW and micro-inflammatory state are very common in PHD patients.Patients with longer duration of dialysis,elderly or associated with diabetic nephropathy are more likely to suffer PEW and micro-inflammatory.Elderly,the time of dialysis duration,microinflammatory state,hypoalbuminemia are the independent risk factors of PEW.

Objective: To describe the current status of the prevalence of co-morbid myopia and obesity among 7-18 years students in the Inner Mongolia Autonomous Region in 2021 and to analyze the moderating effect of lifestyle in this association ，so as to provide scientific basis for the establishment of the mechanism of Co-morbidity，Shared Etiology，and Shared Prevention of common diseases in children and adolescents. Methods: A total of 139 630 primary and secondary school students aged 7-18 years from Inner Mongolia Autonomous Region were selected by stratified random cluster sampling method in September,2021. Myopia was determined using distance visual acuity examination and refractive error examination, and obesity was determined according to the BMI classification criteria for overweight, obesity screening of Chinese school age children and adolescents. Used a questionnaire, healthy lifestyles were determined according to the American Heart Association s Healthy Lifestyle Score by totaling the six scores for smoking, alcohol consumption, diet, exercise, screen time, and sleep duration.The χ 2 test was used to compare the association between group differences in the co-morbidity rate of myopia and obesity. The multivariable Logistic regression model was used to explore the influencing factors of the co-morbidity of myopia and obesity, and the stratified analysis was used to analyze the moderating effect of lifestyles on the prevalence of the co-morbidity. Results: The prevalence of myopia and obesity co-morbidity among students aged 7-18 years old in the Inner Mongolia Autonmous Region in 2021 was 13.7%, higher among boys than girls ( 15.5 % vs. 11.8%), higher among those aged 10-12 years old than 7-9,13-15,and 16-18 years old (14.7%,13.7%, 13.3%, 12.0%), higher among other ethnic minorities than Han Chinese and Mongolians (15.3%, 14.0%, 12.5%), higher in urban areas than that in suburban areas(15.3%, 13.0%), and middle economic level tracts were higher than poor and good tracts (14.8%, 12.9 %, 12.6%) ( χ 2=392.37，115.73，62.80，119.02，121.60, P <0.05). Multivariable Logistic regression modeling showed that unhealthy lifestyles ( OR=1.24, 95%CI=1.19-1.29 ) and middle level of lifestyle score ( OR=1.15, 95%CI=1.10-1.19 ) students had higher prevalence of co-morbidity, and the results were statistically significant among both boys and girls, the age groups of 10- 12, 13-15, and 16-18 years old, as well as the Han and Mongolian ethnic groups (all P <0.05). Conclusion In 2021, the current situation of myopia and obesity co-morbidity and unhealthy lifestyles among primary and secondary school students in the Inner Mongolia Autonomous Region are not optimistic.