Objective To compare the prevalence of microvascular and macrovascular complications between adult latent autoimmune diabetes(LADA)and type 2 diabetic subjects.Methods A cross-sectional study was performed in 203 LADA(GADA positive)and 203 T2DM(GADA negative)subjects matched with age,gender and duration as well as family history of diabetes.Parameters of microvascular(albuminuria、eyeground microscopy or fundus fluorescence photography,electromyogram)and macrovascular complications(electrocardiogram,blood pressure,blood lipid,body mass index)as well as blood sugar were compared.Results ①Microvascular complications:Compared with T2DM,LADA cases showed higher prevalence of diabetic nephropathy(39.9%vs.28.6%,P＜0.05)and similar prevalence in diabetic neuropathy and retinopathy(P＞0.05).②Macrovascular complications:LADA cases presented lower prevalence of hypertension(38.9%vs.55.7%,P＜0.01),lower prevalence of metabolic syndrome (33.0%vs.45.3%,P＜0.01＝,but similar orevalence of coronarv heart disease (CHD) and erebral infarction(CVD)(P＞0.05).Conclusion LADA patients present less metabolic syndrome,hypertension and more diabetic nephropathy compared with T2DM.

Objective To analyze the literature of snakebite and tetanus infection at home and abroad, and understand the situation of tetanus in snakebite patients.Methods The retrieval of China CNKI database, Wanfang database, VIP database and MEDLINE, Web of Science Embase and Science Direct database was performed with “snake bite” and “tetanus” as the key words, and the retrieval time from January 1953 to October 2017.Results A total of 98 articles was retrieved, which clearly records the snakebite patient data with tetanus has collected 8 literatures, Chinese 6 literatures, English 2 articles;a total of 16 patients, including 11 cases of Chinese, 4 in Nigeria, 1 in Thailand;the bite sites were limbs;9 patients with blood circulation the snake wound, 7 cases of mixed snakebite;snake bite patients with tetanus before;1 patients were injected with Tetanus Antitoxin, 13 patients were treated with Chinese herbal medicine on the wound, 2 patients were untreated.Prognosis analysis showed that in 16 cases, 12 cases were cured, 4 cases died, and the death of the patients had the history of herbal.Conclusions The prevention of tetanus infection should be strengthened in patients with extremities trauma, external application of herbs, blood based drugs, or mixed venomous snake bites.

Objective    To evaluate the significance of lactate dehydrogenase (LDH) as a predictor of in-hospital mortality in patients with acute aortic dissection(AAD). Methods     We conducted a retrospective analysis of the clinical data of 445 AAD patients who were admitted to the Second Xiangya Hospital of Central South University and the Changsha Central Hospital from January 2014 to December 2017 within a time interval of ≤14 days from the onset of symptoms to hospital admission, including 353 males and 92 females with the age of 45-61 years. LDH levels were measured on admission and the endpoint was the all-cause mortality during hospitalization. Results    During hospitalization, 86 patients died and 359 patients survived. Increased level of LDH was found in non-survivors compared with that in the survived [269.50 (220.57, 362.58) U/L vs. 238.00 (191.25, 289.15) U/L, P<0.001]. A nonlinear relationship between LDH levels and in-hospital mortality was observed. Using multivariable logistic analysis, we found that LDH was an independent predictor of in-hospital mortality in the patients with AAD [OR=1.002, 95% CI (1.001 to 1.014), P=0.006]. Furthermore, using receiver operating characteristic (ROC) analysis, we observed that the best threshold of LDH level was 280.70 U/L, and the area under the curve was 0.624 (95% CI 0.556 to 0.689). Conclusion    LDH level on admission is an independent predictor of in-hospital mortality in patients with AAD.