High-fat diet has led to rapid increase in population withdyslipidemia due to the improvement of living standard, which has seriously endangished people′s health.Blood lipid examination is the an important method to diagnose and monitordyslipidemia.Precision detection and proper management can effectively help doctor to diagnose and treat dyslipidemia.This article mainly introduced international and domestic guidelines about dyslipidemia and related progress as well as highlightin this field.Meanwhile, we provided several advices on dyslipidemia from various perspectives.Clinical laboratory related personnel should analyze the influenced factors on blood lipid test examination at pre-test, on-test and post-test and providebetter detection and managementfor blood lipid.

Objective To observe the effects of intensive lower extremity motor control training on the motor function of lower extremity, balance and walking capability of stroke patients. Methods 40 stroke patients were randomized into the intervention group (n=20) and control group (n=20). Both groups received the routine rehabilitation, while the intervention group accepted the lower extremity motor control training in addition for 6 weeks. Before and after 6 weeks of treatments, they were assessed with Fugl-Meyer Assessment of lower extremity (FMA-L), Berg Balance Scale (BBS), Holden Functional Ambulation Category (FAC); their gaits were analysesd with footprint. Results Both groups improved significantly in scores of FMA-L, BBS, FAC and average step length, stride width, walking velocity (P<0.01) after treatment, and improved more in the intervention group than in the control group (P<0.05). Conclusion Intensive motor control training of lower extremity may promote the recovery of motor function of lower extremities, balance and walking ability of stroke patients.

Objective: To assess the value of multi-parametric MRI in mammographically detected breast imaging reporting and data systems (BI-RADS) 3 to 4 exclusive microcalcifications. Methods: A retrospective analysis was performed in 152 patients with mammographically detected BI-RADS 3 to 4 exclusive microcalcifications from January 2013 to December 2017. All patients underwent bilateral breast multi-parametric MRI before surgical biopsy. Microcalcifications were classified according to BI-RADS by two radiologists with more than 10 years′ experience in breast imaging. The area under the curve (AUC), sensitivity and specificity of BI-RADS 3 to 4 exclusive microcalcifications diagnosis by mammography and mammography plus MRI were calculated and compared using pathology as the gold standard. Results: A total of 152 lesions (93 benign lesionsand 59 malignant lesions) were assessed in this study. The positive predictive value (PPV) of mammography for BI-RADS 3, 4A, 4B and 4C microcalcifications diagnosis were 22.2%(16/72), 5.0%(1/20), 48.5%(17/35) and 100.0%(25/25) respectively. The PPV of MRI for BI-RADS 2, 3, 4, 5 microcalcifications diagnosis were 1.6%(1/62), 7.1%(2/28), 72.2%(13/18) and 97.7%(43/44).The area under curve, sensitivity and specificity of mammography for BI-RADS 3 to 4 microcalcifications diagnosis were 0.676,72.9% and 60.2%. The area under curve, sensitivity and specificity of mammography plus MRI for BI-RADS 3 to 4 microcalcifications diagnosis were 0.982, 94.9% and 93.6%. Conclusions Multi-parametric MRI can improve the diagnostic accuracy in mammographically detected BI-RADS 3 to 4 exclusive microcalcifications, which is helpful to differentiate benign and malignant breast lesions with microcalcifications and avoid unnecessary biopsies.

In Nov 2019, " The Journal of Clinical Endocrinology & Metabolism" published an article " Association of inpatient glucose measurements with amputations in patients hospitalized with acute diabetic foot" [Peled S, Pollack R, Elishoov O, et al. J Clin Endocrinol Metab, 2019, 104(11): 5445-5452. DOI: 10.1210/jc.2019-00774], with the permission of the original journal, we translated it into Chinese. This article studied the relationship of glycemic indices during hospitalization with amputations in patients with acute diabetic foot. The retrospective cohort study included 418 patients admitted with acute diabetic foot in the diabetic foot unit during 2015-2017. Information on demographic characteristics, medical history, laboratory tests, and point-of-care glucose measurements were collected. The primary outcomes were any or major amputation during hospitalization. 45 496 glucose measurements were taken for 418 patients hospitalized with acute diabetic foot. Patients experiencing any hyperglycemia and any or severe hypoglycemia were more likely to undergo any or major amputations during hospitalization. High glycemic variability was associated with major amputations. Peripheral vascular disease, high Wagner score, and hypoglycemia were independent predictors of amputations. Older age, peripheral vascular disease, previous amputation, elevated white blood cell, high Wagner score, and hypoglycemia were independent predictors of major amputations. Hypoglycemia appeared to be an independent risk factor for any and major amputations. While it is unclear whether hypoglycemia directly contributes to adverse outcomes, efforts to minimize in-hospital hypoglycemic events are needed.

Objective:To explore the relationship between AluYb8 insertion in the MUTYH gene and the risk of decreased left ventricular diastolic function in the elderly.Methods:In the retrospective analysis, 498 elderly patients with decreased left ventricular diastolic function(the disease group)and 155 people without left ventricular diastolic function(the control group)were recruited.Polymerase chain reaction was employed to analyze the genotype distribution of AluYb8 insertion in MUTYH gene.Cardiac function was measured by high-resolution color Doppler ultrasound.Results:The frequencies of the A/A, A/P and P/P genotypes were 30.1%(150/498), 48.4%(241/498)and 21.5%(107/498)in patients with decreased left ventricular diastolic function, and 27.7%(43/155), 54.8%(85/155)and 17.5%(27/155)in the control group, respectively.There were no significant differences in genotype( χ2=2.162, P=0.339)and allele frequency( χ2=1.342, P=0.794)between the two groups.Further analysis after stratification revealed that there were statistically significant differences in genotype( χ2=7.173, P=0.028)and allele frequency( χ2=8.352, P=0.015). Multivariate Logistic regression analysis showed that, in elderly patients with diabetes, P-allele carriers had a higher risk of decreased left ventricular diastolic function than non-carriers( OR=3.450, 95% CI: 1.148-10.372, P=0.027). Conclusions:AluYb8 insertion in the MUTYH gene may be associated with the risk of decreased left ventricular diastolic function in the elderly with diabetes.

This paper was aimed to study the effect of Qing-Chang Wen-Zhong (QCWZ) decoction on interferon gamma induced protein 10 (IP10) in colon tissues of rats with ulcerative colitis (UC).The UC model was induced using 4.5％ DSS added to distilled water for 7 days.At the same time,low-,medium-and high-dose of QCWZ decoction and mesalazine was given by gavage route daily.Then,the rats were killed and the colon tissues were taken.Expression level of interleukin-1 alpha (IL-1α),IL-1β,IL-6,tumor necrosis factor alpha (TNF-α) and interferon gamma (INF-γ) in colon were detected by Elisa assay.The expression and distribution of IP10 protein were detected by immunohistochemistry (IHC).The results showed that compared with the normal group,inflammatory factors (IL-1α,IL-1β,IL-6,TNF-α,INF-γ) and IP10 expression level in DSS-induced UC rats were significantly increased.After 7 days of intervention,inflammatory factors (IL-1α,IL-1β,IL-6,TNF-α,INF-γ) and IP10 decreased significantly (p＜0.01,p＜0.05).It was concluded that QCWZ decoction may down-regulate the expression of IP 10 and inflammatory factors (IL-1α,IL-1β,IL-6,TNF-α,INF-γ),and then inhibit intestinal inflammation and repair intestinal mucosal damage,so as to achieve the purpose of UC treatment.

Objective Secondary infection with pseudomonas aeruginosa( PA) in diabetic foot ulcer( DFU) was analyzed to investigate the related risk factor, antibiotic resistance, and prognoses of the infection. Methods Pathogen cultures were carried out in 966 DFU patients with their clinical data collected. All of the patients were followed-up for two years to observe the outcomes, including ulcer healing, amputation, recurrence of ulcers, non-fatal cardiovascular events, and death. The antibiotic susceptibility, risk factors and associated outcome of secondary PA infection were analyzed. Results Total incidence of PA infection was 13. 0％ in DFU patients, of which 38. 1％was secondary. The susceptibility rates of secondary infected PA to tobramycin, meropenem, eftazidime, levofloxacin, cefepime, and cefepime were similar to those in primary infected PA. However, the susceptibility rates of secondary infected PA to piperacillin, piperacillin/tazobactam, ciprofloxacin, imipenen, gentamicin, aztreonam, and amikacin decreased by 12％ to 22％ as compared with primary infected PA. The healing rate was much lower in patients with secondary PA infection compared with those with primary PA infection, and the accumulated healing rates at2yearswere44.44％ and70.4％ (P=0.01) respectively. Theriskofulcerhealingfailurewithintwoyears increased by 3 folds in patients with secondary PA infection. After adjusting for age, sex, Wagner grade, infection grade, and duration of DFU, plasma albumin level was an independent risk factor for secondary PA infection in patients with DFU(P=0. 001). Conclusions The antibiotics susceptibility rates of secondary infected PA were lower than those of primary infected PA. Secondary PA infection in DFU was less likely to be healed. Plasma albumin level was a risk factor for secondary PA infection.

Objective Synthetic cannabinoids(SCs)will be widely metabolized to phase I metabolites and glucuronide metabolites after entering human body.It is usually difficult to detect the parent drug of SCs in urine.Therefore,it is necessary to undergo de-glucuronidation in the preparation of urine samples.We aimed to optimize the enzymatic hydrolysis methods for SCs detection in urine.Methods We studied enzymatic hydrolysis for the determination of 11-demethyl-9-carboxyl-THC(Δ9-THC-COOH)in THC positive urine samples by liquid chromatography-tandem mass spectrometry(LC-MS/MS),and compared it with the alkaline digestion method.Meanwhile,we studied enzymatic hydrolysis for the determination of the related metabolites in MDMB-4en-PINACA and ADB-BUTINACA positive urine samples.Results The Δ9-THC-COOH glucuronic acid conjugate could be hydrolyzed by adding 3μL β-d-glucuronidase solution(＞100 000 units/mL)for 30 min at 55℃.The MDMB-4en-PINACA M and ADB-BUTINACA M glucuronide conjugates were hydrolyzed by adding 3μL β-d-glucuronidase solution(＞100 000 units/mL)for 30 min at 75℃.Conclusion This study can provide reference for the establishment of rapid,accurate and reliable enzymatic hydrolysis methods when detecting SCs in urine.

Objective:To summarize the patient profiles and therapeutic efficacies of ABO-incompatible living-related kidney transplantations at 19 domestic transplant centers and provide rationales for clinical application of ABOi-KT.Methods:Clinical cases of ABO-incompatible/compatible kidney transplantation (ABOi-KT/ABOc-KT) from December 2006 to December 2009 were collected. Then, statistical analyses were conducted from the aspects of tissue matching, perioperative managements, complications and survival rates of renal allograft or recipients.Results:Clinical data of 342 ABOi-KT and 779 ABOc-KT indicated that (1) no inter-group differences existed in age, body mass index (BMI), donor-recipient relationship or waiting time of pre-operative dialysis; (2) ABO blood type: blood type O recipients had the longest waiting list and transplantations from blood type A to blood type O accounted for the largest proportion; (3) HLA matching: no statistical significance existed in mismatch rate or positive rate of PRA I/II between two types of surgery; (4) CD20 should be properly used on the basis of different phrases; (5) hemorrhage was a common complication during an early postoperative period and microthrombosis appeared later; (6) no difference existed in postoperative incidence of complications or survival rate of renal allograft and recipients at 1/3/5/10 years between ABOi-KT and ABOc-KT. The acute rejection rate and serum creatinine levels of ABOi-KT recipients were comparable to those of ABOc-KT recipients within 1 year.Conclusions:ABOi-KT is both safe and effective so that it may be applied at all transplant centers as needed.