Objective:To explore the metabolic outcomes of type 2 diabetes patients with different durations after 1 year treatment under the standardized metabolic disease management model.Methods:(1)From September 2017 to September 2018, 345 type 2 diabetes patients in the Standardized Metabolic Management Center(MMC) of Shanghai General Hospital were recruited and included in this research. They were divided into newly-diagnosed type 2 diabetes(duration≤1 year) and long-term groups(duration>1 year). The general characteristics, blood pressures, glycemic levels, lipids levels, control rates and comprehensive compliance rates(blood glucose, pressure and lipids all reached targets) were compared at baseline between 2 groups.(2)All patients underwent one year standardized management, and metabolic indicators mentioned above and control rates at the time were compared as well.Results:(1) At baseline, compared with long-term group, patients in newly-diagnosed type 2 diabetes group were younger ( P<0.01), and 2 h blood glucose level after glucose loading were higher [(15.20±5.26 vs 13.68±4.94) mmol/L, P<0.01]. (2) After one year standardized management, body weight, blood pressure, glucose and lipids metabolism in all patients were significantly improved. Compared with patients in long-term group, newly-diagnosed type 2 diabetes patients achieved better glycemic level [fasting blood glucose(6.27±1.56 vs 7.63±2.08) mmol/L, P<0.01; glycated hemoglobin(6.33±0.96 vs 7.23±1.37) %, P<0.01] , and had higher HOMA-β [(74.01±56.45 vs 40.17±37.07) %, P<0.01]. The glycemic control, blood pressure and blood lipids control rates in both groups increased significantly in one year. Comprehensive compliance rate of the whole patients increased from 5.80% to 24.06%. The metabolism indexes of the newly-diagnosed type 2 diabetes group were better than those of the long-term group[comprehensive compliance rate: (24.73% vs 17.18%, P=0.087, glycemic control rate(84.62% vs 53.37%, P<0.01)]. Conclusion:Standardized metabolic disease management promoted the overall improvement in blood glucose, blood pressure, and lipids levels in type 2 diabetes patients, especially in terms of blood glucose and those of the newly-diagnosed type 2 diabetes. In the future, we should focus on the early diagnosis and treatment of type 2 diabetes, actively promote the MMC model and stress the integrated management of blood glucose, blood pressure, and blood lipid levels. We should pay more attention to the long-term patients, to improve their awareness and treatment compliance.

Objective: To explore the glycemic control of newly-diagnosed type 2 diabetes with different levels of baseline body mass index (BMI) after 6 months treatment under the standardized metabolic disease management model. Methods: (1) 163 patients of newly-diagnosed type 2 diabetes were divided into normal weight (BMI 18.5-23.9 kg/m²), overweight (BMI 24.0-27.9 kg/m²), and obese (BMI≥28 kg/m²) groups according to baseline BMI, the blood glucose and lipids levels were compared among 3 groups. (2) The blood glucose levels were compared among 3 groups after 6 months of standardized management. (3) The overweight and obese patients were divided into group weight loss≥5% and group weight loss<5% or weight gain in 6 months. The blood glucose levels were compared. Results: (1) At baseline, overweight and obese groups had higher homeostasis model assessment for insulin resistance and lower high density lipoprotein-cholesterol compared with normal weight group. (2) After 6 months of treatment, HbA_1C and HbA_1C reduction showed no difference among 3 groups (normal, overweight and obese) after adjusted by baseline HbA_1C. The rate of HbA_1C<7% among 3 groups were 77.78%, 83.95%, and 80.43% (P>0.05). (3) After 6 months of treatment, 32.28% overweight and obese patients lost weight by ≥ 5%, while HbA_1Cand HbA_1Creduction showed no difference between 2 groups (weight loss≥5% and weight gain or weight loss<5%) after adjusted by baseline HbA_1C. Both groups achieved good glycemic control [(6.27±1.38 vs 6.43±0.66)%], but have no significantly(P>0.05). Group weight loss≥5% had better glucose control (92.68% vs 77.91%, P<0.05). Conclusions As BMI increased, insulin resistance and lipid disorders were more serious in newly-diagnosed type 2 diabetes. After 6 months of standardized metabolic management, newly-diagnosed type 2 diabetes with different baseline BMI and weight changes both achieved good glycemic control. In addition, patients losing weight equal to or more than 5% achieved higher attainment of HbA_1C targets.

Lymphocytic hypophysitis(LYH) is a rare autoimmune inflammatory disorder of the pituitary gland, usually affecting young women in late pregnancy or postpartum period. To enhance the knowledge of LYH, herein we reported a case of LYH in a female during postpartum who presented with pituitary crisis.

Objective:To analyze the prognostic factors and evaluate the accuracy of existing survival prediction models in patients with lung cancer-derived spinal metastases who have undergone open surgery.Methods:According to the inclusion criteria, the data of 76 patients with spinal metastasis of lung cancer who underwent open surgery in the department of Orthopedics in Guangdong Provincial People's Hospital were collected from January 2019 to November 2021. The relationship between the number of bone metastasis, pathological type, visceral metastasis, epidermal growth factor receptor mutation, serum alkaline phosphatase (ALP), hemoglobin (Hb), Frankel grade and postoperative survival time in 76 cases was analyzed by Cox logical regression analysis and Kaplan-Meier method to determine the potential prognostic factors. The accuracy of Tomita score, Tokuhashi revised score, Katagiri New score, New England Spinal Metastasis Score score (NESMS) and Skeletal Oncology Research Group (SORG) machine learning algorithm in predicting postoperative survival time was verified by drawing receiver operating characteristic (ROC) curve.Results:The median follow-up time of the patients was 18.0 months (2.3-36.0 months). The median survival time was 12.6 months [95% CI (10.8, 14.4)]. The survival rates at 6 and 12 months after operation were 71.6% and 52.0%, respectively. Multivariate regression analysis showed that ALP [ HR=0.23, 95% CI (0.11, 0.48), P<0.001], Hb [ HR=4.48, 95% CI (2.07, 9.70), P< 0.001] and EGFR mutation [ HR=2.22, 95% CI (1.04, 4.76), P=0.040] were independent predictors of prognosis. The accuracy of Tomita score, Tokuhashi revised score (2005), Katagiri New score and NESMS score in predicting 1-year mortality was 58.7%, 65.7%, 70.5% and 65% respectively, and the accuracy in predicting 6-month mortality was 63.7%, 62.2%, 61.2% and 56.8% respectively. The accuracy of SORG machine learning algorithm in predicting 1-year and 90 d mortality was 81.1%, 67.5%, respectively. Conclusion:No EGFR mutation, ALP>164 U/L and Hb≤125 g/L were risk factors affecting the survival of patients with spinal metastasis of lung cancer. SORG machine learning algorithm has good accuracy in predicting the postoperative survival rate of patients with lung cancer spinal metastasis.