An article entitled "Adrenal incidentalomas are tied to increased risk of diabetes: findings from a prospective study" published in JCEM in April 2020, was hereby translated into Chinese after obtaining the copyright [Giuseppe R, et al. J Clin Endocrinol Metab, 2020, 105(4): dgz284]. This is a prospective study to explore the frequency of adrenal incidentalomas and their association with comorbid diseases. It recruited 601 patients who underwent abdominal CT scan in the radiology department at a public hospital. Those with any history or doubt of adrenal diseases or malignancy were considered as non-eligible. In 7.3% of the patients, adrenal incidentalomas were serendipitously found. The patients with an adrenal incidentaloma were with higher body mass index( P=0.009) and higher waist circumference( P=0.007) and were more frequently diabetic(31.8% vs 14.2%, P=0.003 8). Multivariate regression analysis showed that diabetes was significantly associated with the presence of adrenal incidentalomas( P=0.003). Autonomous cortisol secretion was observed in 50% of patients(plasma cortisol≥50 nmol/L after 1 mg dexamethasone). This is the first study showing that the frequency of adrenal incidentalomas is 7.3% in a prospective radiological series avoiding ascertainment bias and adrenal incidentalomas are tied to increased risk of type 2 diabetes.

Objective Analyzing the distribution of 1476 strains of clinical common pathogens and their antimicrobial resistance, provide reference the reasonable use of antimicrobial drugs for clinical.Methods Using BD company PHOEIX-100 Automatic Pathogen Identification to Pathogen identify 1476 strains of pathogens which were got from the various isolated and cultivated samples which were examined from 2009 January to 2010 August and its antibacterial Drug Susceptibility Test, then with WHONET5. 3 system to analyze monitoring data of the pathogen distribution and resistance. Results In 1476 strains of pathogens isolated, gram-negative bacteria had 1206 strains occupying 81.7% ; Gram-positive cocci had 270 stains occupying 18. 3%. The most common detected pathogen were Escherichia coli, Klebsiella pneumoniae,Staphylococcus aureus and Pseudomonas aeruginosa, which accounted for 20. 2% ,17. 5% ,13. 2% ,11.4%.The ESBLs producing E. coli and K. pneumoniae accounted for 65. 9% ,48. 1% ; Also methicillin-resistant S. aureus (MRSA) accounted for 79. 2% and methicillin-resistant coagulase-negative staphylococci (MRCNS) accounted for 68.4%. It isnt found yet that grape genus to vancomycin, nitrofurantoin can resist drug.Gram-negative bacilli to antimicrobial vinyl hydrocarbon mold degree of sensitivity is high. Conclusion The isolated pathogen's resistance of drug is widespread. It is important to guide clinical reasonable use of antibiotics and control infectious pathogens that carry out continuous monitoring of drug resistance.

Objective To investigate the risk factor for new-onset diabetes after transplantation (NODAT) and the relationship between NODAT and arterial stiffness. Methods Oral glucose tolerance test (OGTT) was performed on 195 patients with renal transplantation. The degree of arterial stiffness, which was determined by brachial ankle pulse wave velocity (baPWV), anklebrachial blood pressure index (ABPI) and intima-media thickness (IMT) of the carotid artery, was evaluated. Results Twenty-nine patients diagnosed as NODAT had significantly higher fasting plasma glucose before transplantation, blood pressure and incidence of hepatitis C virus (HCV) infection than in patients without NODAT. Multivariate regression analysis revealed that the risk factor of NODAT was fasting plasma glucose pre-transplantation, HCV infection and systolic blood pressure.The independent determinant of the advanced arterial stiffness on NODAT was the statement of hypertension and age. Conclusions High fasting plasma glucose prior to transplantation, HCV infection and high blood pressure are risk factors for NODAT in patients after renal transplantation.Strict control of blood pressure is the key way to prevent the NODAT and atherosclerosis.

Objective:To select the differentially expressed vascular smooth muscle cell(VSMC) apoptosis gene induced by icariin,glucose regulated protein 78(GRP78),to observe the expression of GRP78 in atherosclerosis tissue and to the elucidate the mechanism of anti-atherosclerosis of icariin.Methods:The model was established by using halfcystine in viro.The vascular smooth muscle cell was incubated with various concentrations of icariin for 48 hours.The apoptosis was detected by TUNEL assay.GRP78 gene was amplificated by PCR,recombinant plasmid were constructed,transfected into E.coli,positive clonings were selected and conf irmed by restriction endonucleas analysis,and sequence-ed.Tissue situ hybridization was used to observe the GRP78 expression in atherosclerosis tissue.Results:Icariin promoted obviously vascular smooth muscle cell apoptosis.Furthermore,the fragment,648bp,was similar to the gene of GRP78 from VSMC,and the expression level was signif icantly higher in high cholesterol group than in control nroup.Conclusions:The GRP78 plays a key role in inducing atherosclerotic lesions.The mechanism of anti-atherosclerosis of icariin might be partly due to promoting apoptosis of vascular smooth muscle cell.

Objective T o infer the frequency of dosage and m edication history investigate of the victim s in drug facilitated cases by the segm ental analysis of clonazepam in hair. Methods Freezing m illing un-der liquid nitrogen environm ent com bined w ith ultrasonic bath w as used as sam ple pretreatm ent in this study, and liquid chrom atography-tandem m ass spectrom etry w as used for the segm ental analysis of the hair sam ples collected from 6 victim s in different cases. T he concentrations of clonazepam and 7-am in-oclonazepam w ere detected in each hair section. Results C lonazepam and its m etabolite 7-am inoclon-azepam w ere detected in parts of hair sections from the 6 victim s. T he occurrence tim e of drug peak concentration w as consistent w ith the intake tim ing provided by victim s. Conclusion Segm ental analysis of hair can provide the inform ation of frequency of dosage and intake tim ing, w hich show s an unique evidential value in drug facilitated crim es.

Objective T o establish a gas chrom atography-m ass spectrom etry (G C-M S ) m ethod for the determ ination of sulfide ion in blood and apply it to the practical cases. Methods T he 1, 3, 5-tribro-m obenzene w as selected as an internal standard, and 0.2 m L blood sam ple w as collected and analyzed using G C-M S after α-B rom o-2, 3, 4, 5, 6-pentafluorobenzyl brom ide derivatization. Results T he m ass concentration of sulfide ion in blood had good linearity in the range of 0.2-40μg/m L w ith a lim it of detection (L O D ) of 0.05μg/m L . T he m ass concentration of sulfide ion w as less than 0.05μg/m L in blank blood from different sources such as healthy subjects and dead cases. In 3 sulfide poisoning cases, sul-fide ion w as detected in the blood sam ples of 6 victim s, and the m ass concentration range w as 1.02-3.13μg/m L . Conclusion T his study establishes a m ethod for investigation of sulfide ion in blood w hich has been applied successfully to the cases of fatal sulfide poisonings.

Objeetive To evaluate the diagnostic value of axially loaded MR imaging with supine position in patients with degenerative disorders of lumbar spine.Methods Thirty asymptomatic volunteers and 89 patients were examined in psoas-relaxed position(PRP)and axially compressed supine position(ACE)of the lumbar spine.Sixty-one patients with low back pain,19 with sciatica and 9 with neurogenic claudication were included in the symptomatic study group.The disc levels from L3 to S1 were examined.Results In 30 asymptomatie volunteers,a significant decrease in dural sac cross-sectional area(DSCA)was found at 14 disc levels(15.6%)in 10 individuals(33.3%)during ACE(>15 mm2).In 89 patients.a significant decrease in DSCA was found at 55 disc levels(20.6%)in 38 patients(42.7%)during ACE(>15 mm2),and the mean decrease was 28 mm2.During ACE,32 disc levels with an increasing severity of disc herniation were noted in 26 patients.16 disc levels with neural foramen stenosis were found in 12 patients,11 disc levels with ligamentum flavum thickening were observed in 10 patients,3 cases facet dislocation and 3 cases lumbar spondylolisthesis were also seen.In 22 of the 89 patients(24.7%).additional valuable information(AVI)was found during ACE,including 7 patients(7/9)with neurogenic claudication,8 patients(8/19)with sciatica,and 11.5%(7/61)of the patients with low back pain.Conclusion As compared with conventional imaging methods,axially loaded imaging provides AVI,and more occult lesions can be found during ACE.ACE MRI is a valuable tool in diagnosing degenerative disorders of lumbar spine.

Objective To assess the classification and characteristics of headaches using the International Classification of Headache Disorders,3rd edition (beta version) criteria in a headache outpatient clinic.Methods In this prospective cross-sectional study,all consecutive patients presenting with headache to a headache outpatient clinic of Peking Union Medical College Hospital between April 1 st,2014 and February 28th,2015 were included.Results The average age of 593 patients was (42.I ± 15.6) years with female-male ratio 1.89∶ 1.Primary headaches were found in 483 (81.5％) patients,of which migraine and tension-type headache were found in 264 (44.5％) patients and 168 (28.3％) patients respectively.Chronic daily headache and new headache were found in 158 (26.6％) patients and 130 (21.9％) patients,while cough headache and thunderclap headache were found in 9 (1.5 ％) patients and 5 (0.8％) patients respectively.Patients with migraine were more likely complicated with medicationoveruse headache than patients with tension-type headache (x2 =4.21,P =0.032).Patients with tensiontype headache were more likely complicated with chronic daily headache than patients with migraine (x2 =18.92,P =0.000).Conclusions In this headache outpatient clinic,most patients were primary headaches.Chronic daily headache and new headache were common,while cough headache and thunderclap headache were uncommon.These headache syndromes should be paid attention to identify the possible underlying malignant etiologies.

AIM: To select differentially the expressed gene,glucose regulated protein 78(GRP78),to observe the expression of GRP78 in atherosclerosis tissue and to elucidate the mechanism for anti-atherosclerosis of puerarin.METHODS: The model was established by using homocysteinemia in vitro.The vascular endothelial cells were incubated with various concentrations of puerarin(10 -7 mol/L,10 -6 mol/L,10 -5 mol/L) for 48 h.The apoptosis rate was detected by flow cytometry using Annexin/PI-staining.GRP78 gene was amplificated by PCR.These differentially expressed fragments were cloned,selected,confirmed,and sequenced.Digoxigenin-labeled DNA Probe and cholesterol-rich rabit model were prepared,GRP78 mRNA was determined by in situ hybridization in atherosclerotic lesions and normal tissue.RESULTS: Three concentrtions of puerarin significantly inhibited the apoptosis of endothelial cells.The early apoptosis rate was decreased magnificently in a dose dependent manner compared with that of HCY group (P

Dual coding is a phenomenon which refers to a mature mRNA that contains two open reading frames(ORFs) in the same direction to code two different proteins.This phenomenon is quite common in prokaryote,bacteriophages and viruses as an economical and effective way to present the genome information.However,recent reports suggest that the dual coding phenomenon does also occur in eukaryote.Dual coding will help us to further understand the complicated regulation of eukaryotic genes or even the law of molecular evolution.