Objective:To investigate the correlation between the secreted frizzled related protein 5 (SFRP5), 25-hydroxy vitamin D [25(OH)D], retinol binding protein 4 (RBP4) and the degree of illness in elderly patients with type 2 diabetes mellitus (T2DM) and the evaluation value of curative effect.Methods:One hundred and thirteen elderly patients with T2DM who treatment in Taihu Hospital of Wuxi City from January 2018 to October 2019 were selected as the study group, and 113 healthy patients during the same period were selected as the control group. The serum levels of RBP4, SFRP5, and 25(OH)D were compared between the two groups, patients with different disease levels, and patients with or without vascular complications. Spearman was used to analyze the correlation between each index and the degree of illness, and Pearson was used to analyze the correlation between each index and the insulin resistance index (HOMA-IR). The receiver operating characteristic (ROC) curve and area under ROC (AUC) were used to analyze the value of SFRP5, 25(OH)D, RBP4 and the combination of the three to predict vascular disease in T2DM patients.Results:The levels of RBP4 , HOMA-IR in study group were higher than those in control group: (22.96 ± 2.26) μg/L vs.(11.28 ± 1.69) μg/L, 3.83 ± 0.70 vs.1.65 ± 0.59, the levels of SFRP5, 25(OH)D in study group were lower than those in control group: (9.28 ± 3.14) μg/L vs. (14.65 ± 3.38) μg/L, (32.65 ± 5.12) nmol/L vs. (51.29 ± 6.33) nmol/L, and the differences were statistically significant ( P<0.05). The level of RBP4 in severe group was higher than that in mild group:(26.91 ± 2.51) μg/L vs. (19.35 ± 2.23) μg/L, the levels of SFRP5, 25(OH)D in severe group were lower than those in mild group: (7.13 ± 2.98) μg/L vs. (11.25 ± 3.30) μg/L, (27.97 ± 4.56) nmol/L vs. (36.93 ± 5.50) nmol/L, and the differences were statistically significant ( P<0.05). The levels of SFRP5, 25(OH)D in patients with macrovascular disease were the lowest, followed by those with microvascular and those without vascular disease; the level of RBP4 in patients with macrovascular disease was the lowest, followed by those with microvascular and those without vascular disease, and the differences were statistically significant ( P<0.05). There was a positive correlation between RBP4 and the degree of illness and HOMA-IR ( P<0.05), and there was a negative correlation between 25(OH)D and SFRP5 and the degree of illness and HOMA-IR ( P<0.05). The AUC of SFRP5 for predicting vascular disease was 0.721, and the cut-off value was ≤11.14 μg/L , with a sensitivity of 78.21%, and a specificity of 60.00%.The AUC of 25(OH)D for predicting vascular disease was 0.786, and the cut-off value was ≤ 36.56 nmol/L, with a sensitivity of 87.18%, and a specificity of 65.71%. The AUC of RBP4 for predicting vascular disease was 0.816, and the cut-off value was greater than 21.45 μg/L , with a sensitivity of 57.69% and a specificity of 94.29%. The AUC of SFRP5 + 25(OH)D + RBP4 for predicting vascular disease was 0.847, with a sensitivity of 70.51% and a specificity of 85.71% ( P<0.05). Conclusions:In severe T2DM elderly patients with vascular complications, the levels of blood SFRP5, 25(OH)D and RBP4 are increased and significantly related to the patient′s condition and insulin resistance, and they can predict the occurrence of vascular disease.

[Objective]To review our experience in treatine infection after total knee arthroplasty with debridement and component retention to determine To the feasibility,indication,factors related to success and failure,and the main points of technique.[Method]Since 1990 to 2004,9 patients were treated with debridement and component retention at our department.[Result]Four of 9 patients successfully retained their component at most recent follow-up,without ongoing infection(mean 18 months,range 10～25 months).We have not draw the statistically significant factors that related to successful and failure,but the factors such as acute infection,surfacing replacement,immediate debrided after onset of symptoms,and the bacteria sensitive to antibiotic were relate to success.[Conclusion]Debridement and component retention can be used in acute postoperative infection and later acute hematogenous infection after total knee replacement,but timing and indication must be chosen strictly.

Objective To explore the relationship among regulatory emotional self-efficacy,Internet overuse and personality,in order to provide the basis for reducing the incidence of Internet overuse and formulating relevant intervention.Methods Bv cluster sampling method,a questionnaire survey was conducted among 1750 students in a university.Results There was a statistically significant difference in gender(t=5.47,P＜0.05) and grades(F=6.11,P＜ 0.05) of Internet overuse.The rate of college students' Internet overuse was 19.92％.The scores of personality of intelligence,stability,perseverance,boldness,sophistication and self-discipline in Internet overuse group were lower than the normal use group(t=1.73-6.01,P＜0.05),but the scores of dimensions of aggressiveness,suspicion,anxiety and tension were higher(t=-7.74--2.61,P＜0.05).The total scores of regulatory emotional self-efficacy were lower in Internet overuse group(t=5.538,P＜0.05).There was a significant negative correlation between the scores of Internet overuse and the scores of regulatory emotional self-efficacy(P＜0.05).The scores of Internet overuse were significant positive correlation with suspicion,anxiety and tension,but significant negative correlation with stability,excitability,perseverance,boldness and self-discipline (P＜0.05).There was a significant positive correlation between the scores of regulatory emotional self-efficacy and intelligence,stability,dimensions of aggressiveness,excitement,perseverance,boldness and self-discipline of personality,but significant negative correlation with suspicion,anxiety and tension(P＜0.05).Regulatory emotional self-efficacy played a partial mediating role in Internet overuse and personalitv traits,the rate respectively was 30.8％,16.7％,14.5％,37.3％.Conclusion There were a closely relationship among regulatory emotional self-efficacy,Internet overuse and personality.Regulatory emotional self-efficacy played a partial neliating role in Intemet overuse and personality traits.

Objective To investigate and analyze the application and effect of the course of Labo-ratory diagnostics in general medical training from the Navy physicians. Methods 37 students attending the general medical training in our university in September 2015 were selected as the subject. At the end of the course, the “Questionnaire Survey on Teaching Feedback” was designed and conducted among them to understand the students'!opinions on the arrangement, teaching content and teaching methods of the experi-mental diagnostics. A total of 37 questionnaires were issued and retrieved effectively and the survey data were collected and summarized. Results Among 37 questionnaires, 100%of trainees (n=37) thought it was necessary to set up the Laboratory diagnostics course in the general medical training, 72.9%(n=27) suggested 3 to 4 teaching hours, and on the demand side of teaching content settings, 91.9%(n=34) chose analyses of blood, urine, stool routine tests and then tests of liver and kidney function. The proportions of students to recommend theory teaching, case discussion and practice operation were 24.3% (n=9), 51.4% (n=19) and 48.6% (n=18) respectively. Conclusions The setup of the Laboratory diagnostics course plays an active role in the general medical training from navy physicians. In the future, according to the demand of the general medical training, teachers should optimize the teaching contents and learning hours, improve the teaching methods and enhance the training quality.

Objective To evaluate the appropriateness of hospitalization days at a tertiary hospital in 2014 by means of the Appropriateness Evaluation Protocol ( AEP ) , and to analyze the causes of inappropriate stays. Methods Medical records of inpatients admitted at a tertiary hospital in 2014 were randomly selected. AEP( US version) was used to evaluate the appropriateness of every hospitalization day, while the causes of inappropriate hospitalization day were also analyzed. Results A total of 1 641 days of stay from 148 medical records were reviewed, and 129 days of stay (7. 9%) were seen as inappropriate. Two major factors for inappropriate stays were waiting for surgery and waiting for test, roughly 89. 1% of the inappropriate hospitalization days. The proportion of inappropriate hospital stays reduced to 4. 8% after adjustment of two-day weekend. Inappropriate hospital stays mostly appeared during the second day to the eighth day after admission(93. 8%). Logistic analysis results showed that with concomitant symptoms, preoperative waiting days > 5 days, high level surgery, non-emergency admission were significantly associated with appropriateness of hospital stays (P<0. 05). Conclusions The rate of inappropriate stays will be reduced and the quality of medical services will be improved if comprehensive measures could be carried out according to the causes of inappropriate stays.

Objective:A study was conducted to observe and compare the efficacy and safety of endostar combined with peme-trexed in elderly patients with advanced lung adenocarcinoma. Methods:Sixty advanced lung adenocarcinoma (ⅢB-Ⅳ) patients who never received any therapy were included. The patients were divided into two groups. One group comprised endostar treatment com-bined with pemetrexed (26 cases of males, 15 cases of females, and 11 cases of individuals aged 65 years old to 78 years old), and the other group comprised pemetrexed only (34 cases of males, 20 cases of female, and 14 cases of individuals aged 65 years old to 78 years old). The two groups were treated for 4 to 6 cycles, and evaluation of treatments was performed every two cycles. Results:The endostar group was re-treated for 80 cycles, and the average cycle was 3.1. The group without endostar was re-treated for 115 cycles. The short-term effects are as follows. The total effective rates (RRs) in the experimental and control groups were 23.1%and 14.7%, re-spectively, and the difference was statistically significant (P<0.05). The disease control rate (DCR) was not significantly different (P>0.05). For pleural effusion, RR and DCR were significantly better in the experimental group than in the control group (P<0.05). In the experimental group, compared with PD, the microvessel density (MVD) in the DCR showed higher expression, and a statistically signif-icant difference (P=0.03) was observed. In the control group, compared with PD, the MVD in the DCR also showed higher expression, but no significant difference (P=0.73) was observed. The long-term effects were as follows: median progression-free survival (PFS), median survival, and side effects between the two groups were not significantly different (P>0.05). Conclusion: Endostar combined with pemetrexed showed increase in total efficiency in elderly patients with lung adenocarcinoma, and malignant pleural effusion was controlled without increasing the toxicity of chemotherapy. MVD can be used as a predictor of Endostar application.

OBJECTIVE To evaluate the results of superficial parotidectomy with preservation of the Steven’s duct. METHODS 27 cases of superficial parotidectomy with preservation of the Steven’s duct were reviewed retrospectively. Complications and treatment outcomes were analyzed. RESULTS Almost all cases investigated resulted in satisfactory outcomes. CONCLUSION Superficial parotidectomy with preservation of the Steven’s duct is a possible alternative for some patients, especially those with benign parotid tumour.

OBJECTIVE: To study the antidepressant effects of total flavone of A( TFA) on post stroke depression ( PSD) in rats. METHODS: Middle cerebral artery occlusion ( MCAO) followed by isolation feed and irritable stimuli was used to induce PSD. Behaviours of rats were detected by open- field test . The effects of TFA on the indexes of hemorheology and brain homogenate lipid peroxidation were also tested. RESULTS: TFA could increase the crossing and rearing scores in open- field test, inhibit the elevation of whole blood viscosity as well as plasma viscosity at high- middle- low shear rates, increase the erythrocyte deformation, enhance the activities of Superoxide Dismutase ( SOD) and Glutathione Peroxidase ( GSH- Px) , and reduce Malondialdehyde ( MDA) content in brain homogenate in PSD in rats. CONCLUSIONS: TFA produces an antidepressant- like effect in PSD rats. This mechanism may be in association with attenuating hemorheological parameters and decreasing lipid peroxidative damage.

Objective To investigate the cytotoxicity and radiosensitization of 5-nitroindazole-3-formyliminodiacetic acid on HeLa cells.Methods HeLa cells in exponential growth phase were incubated in culture media with different doses and the survival rate was determined by MTT assay.The survival rate of cells receiving radiation combined with different doses of medicine was compared with that of the control.Results The cytotoxicity of S-nitroindazole-3-formyliminodiacetic acid on HeLa cells was very low.The drug had hypoxia radiosensitizing effect on HeLa cells.At doses of 0,6,12,24,48 and 96 μg/ml under hypoxia ,the survival rate were 0.91 ,0.87,0.84,0.81 ,0.76 and 0.60,respectively.At the dosage of 48 and 96 μg/ml,the survival rate were 0.85 and 0.73 under oxygenous).Conclusions 5-Nitroindazole-3-formyliminodiacetic acid has low cytotoxicity and rediosensitizing effect on HeLa cells.

Objective To evaluate the performance of ultrasonography (US) for the preoperative staging of papillary thyroid carcinoma (PTC). Methods One hundred and twenty-one patients with cytologically proven PTC were prospectively collected. Patients were recruited at the Chinese Academy of Medical Sciences Cancer Hospital from January 2014 to November 2014. Preoperative US was performed for the evaluation of primary tumor size, extrathyroidal extension and neck lymph node metastasis according to the 6th UICC TNM staging system. Results The sensitivity, specificity, positive predictive value (PPV) and negative predicative value (NPV) of US in predicting extrathyroidal extension were 89.6%(60/67), 72.2%(39/54), 80.0%(60/75), 84.8%(39/46), respectively. The accuracies of preoperative US for T1, T2, T3, T4 stage were 75.0%(36/48), 100%(1/1), 81.9%(59/72), 0, respectively. The sensitivity, specificity, PPV, and NPV of US in predicting neck lymph node metastasis were 47.5%(29/61), 90.0%(54/60), 82.9%(29/35), 62.8%(54/86), respectively. Conclusion Ultrasonography is a feasible tool for preoperative staging of PTC and is helpful for accurate prediction of extrathyroidal tumor extension and lateral neck lymph node metastasis.