Objective: To preliminarily establish the reference interval for serum creatinine in healthy adults aged 20-79 years in city of Lianyungang. Methods: A total of 34 577 cases of reference individuals were selected from physical examination population by using the principle of complete randomization, and the concentration of serum creatinine was detected by AU5821 automatic biochemical analyzer with its matching reagents.According to the standards of CLSI C28-A3 and WS/T 402-2012 " Clinical Laboratory Test Project Reference Interval Formulation" , the reference interval of serum creatinine was established. Results: There was statistically significant difference of serum creatinine in gender and age between healthy adults in this area (male group: 78[72-84]μmol/L, female group: 61[56-66]μmol/L; aged 20-59 of male group: 78[72-84]μmol/L, aged 60-79 of male group: 77[70-85]μmol/L; aged 20-59 of female group: 60[56-65]μmol/L, aged 60-79 of female group: 63[58-69]μmol/L) (Z=120.93, Z=31.53, Z=28.45; all P<0.05). Therefore, the reference interval of serum creatinine was established based on gender and age, and its reference interval was 61-97μmol/L (aged 20-59 of male), 60-106μmol/L (aged 60-79 of male), 47-76μmol/L (aged 20-59 of female) and 49-86μmol/L (aged 60-79 of female), respectively. Conclusion Establishment of reference interval in serum creatinine plays an important role in the auxiliary diagnosis, progression and prognosis evaluation of various kidney diseases.

Objective To investigate the value of serum amyloid A (SAA) and retinol binding protein (RBP) in diagnosis of early type 2 diabetic kidney disease (DKD).Methods A total of 182 type 2 diabetic patients hospitalized in department of Endocrinology and Nephrology of Lianyungang Second People's Hospital from January to December 2017 were randomly collected as subjects.According to urinary albumincreatinine ratio (UACR),all subjects were divided into three groups of normal albuminuria group (NA,60 cases),microalbuminuria group (MA,63 cases) and clinical proteinuria (CP,59 cases).In the same period,60 healthy persons were selected as normal control (NC).The levels of serum SAA and RBP were detected by automatic biochemical analyzer.Receiver operating curve (ROC) was used to analysis the diagnostic efficiency of DKD and the risk factors of DKD were further estimated.Results The levels of SAA were (6.88±2.82) and (37.21±20.58) mg/L in control group and case group.And levels of serum SAA in the NA group,MA group and CP group were (16.33±5.98),(40.97± 15.62),(54.43±22.91) mg/L respectively.The levels of RBP were (37.56± 10.51) and (69.26±21.23) mg/L in control group and case group.And levels of RBP in the NA group,MA group and CP group were (52.66 ± 14.31),(69.66 ± ± 15.52),(85.70± 19.51) mg/L respectively.The concentrations of serum SAA and RBP in type 2 diabetic patients were significantly higher than those normal controls (t =10.36,P＜0.05;t =11.11,P＜0.05) and increased with DKD progression (F =83.6,P＜ 0.05;F =59.2,P＜ 0.05).Diagnostic sensitivity of serumSAA,RBP in DKD was 81.8％ and 84.1％ respectively.Diagnostic sensitivity of combined detection was 90.9％.Regression analysis showed that SAA,RBP and UACR were independent risk factors for DKD (OR (95％ CI) =1.391 (1.068-1.812),1.212 (1.085-1.353),1.148 (1.038-1.270);all P ＜0.05).Conclusion Both of serum SAA and RBP were significantly elevated in diabetic patients with renal injury so that they had great value in early diagnosis of DKD.

Objective:To evaluate whether index of microcirculatory resistance(IMR)is associated with left ventricular(LV)remodeling in acute anterior ST elevation myocardial infarction(STEMI)pa-tients undergoing primary percutaneous coronary intervention(PPCI).Methods:This was a single-center retrospective cohort study.The patients with first anterior STEMI who received PPCI from January 2014 to August 2017 in Peking University Third Hospital was enrolled.After PPCI,IMR was measured immediately by using pressure/temperature guidewire.The success rate of IMR measurement was 100％.Also we collected some related clinical data from the medical records and laboratory results.Infarct size[assessed as creatine kinase(CK)peak],echocardiography at baseline and 1 year follow-up were as-sessed.LV adverse remodeling(LVAR)was defined as ≥20％increase in LV end-diastolic volume(LVEDV).Results:A total of forty-three patients were enrolled,with an average age of(58.7±12.4)years.The patients were divided into two groups as IMR ≤25 and IMR＞25 by normal values recommen-ded by previous literature.Compared with IMR ≤25 group,IMR＞25 group had a higher percentage of initial thrombolysis in myocardial infraction(TIMI)grade 0(95.7％vs.65.0％,P=0.029),higher serum CK peak value[4 090(383,15 833)vs.1 580(396,5 583),P=0.004].The IMR＞25 group suffered higher rates of ventricular aneurysm(30.4％vs.5.0％,P=0.021).There was no difference in LVEDV[(111.0±18.8)mL vs.(115.0±23.6)mL,P=0.503]between the two groups 1 day after MI,but after 1 year,LVEDV in IMR＞25 group was significantly higher than in IMR≤25 group[(141.5± 33.7)mLvs.(115.9±27.9)mL,P=0.018].The incidence of LVAR was more significant in IMR＞25 group(47.4％vs.11.8％,P=0.024).Binary Logistics regression showed that IMR[B=0.079,exp(B)(95％CI)=1.082(1.018-1.149),P=0.011]and serum triglyceride level[B=1.610,exp(B)(95％CI)=5.005(1.380-18.152),P=0.014]were the predictors of LVAR 1 year after MI.IMR had a good predictive value for LVAR 1 year after MI[area under the curve(AUC)=0.749,P=0.019],IMR＞29 was a good cutoff value with sensitivity 81.8％and specificity 68.0％.Conclusion:Our study elaborates that immediate measurement of IMR after PPCI in patients with STEMI can reflect the microvas-cular function.And IMR could be used as a quantitative biomarker to predict LVAR after STEMI.