Objective To study the changes and significance of CD4+CD25+ regulatory T cells and C-reactive protein(CRP) in patients with acute exacerbation of chronic obstructive pulmonary disease(COPD). Methods Flow cytometry was used to detect the frequency of CD4+CD25+ regulatory T cells in peripheral blood from 36 patients with acute exacerbation of COPD( COPD group) and 36 patients with clinical stability of COPD(control group one)and 36 normal individuals(control group two). The level of CRP was detected routinely. Results The ratio of CD4+CD25+ regulatory T cells number in peripheral blood of COPD group to the total number of CD4+T cell was (2.56±1.83 )%, and it was significantly decreased compared to the other two groups (P all<0.01 ). The level of CRP in COPD group was markedly higher than that in the other two groups (P all<0.01 ). The level of CD4+CD25+ regulatory T cells in patients with acute exacerbation of COPD had negative relation with CRP. Conclusions CD4+CD25+ regulatory T cells participate in inflammatory response. The proportion of CD4+CD25+ regulatory T cells decreases in patients with acute exacerbation of COPD, and it may result in maladjustment of cytoimmunity.

Objective The aim of this study was to investigate the possible effect of glycated low density lipoprotein ( LDL ) on the proliferation, differentiation, and expression of low-density lipoprotein receptor-related protein5(LRP5)mRNA,dickkopf-1(DKK1)mRNAinmouseosteoblasts(MC3T3-E1cells). WhethertheWnt signaling pathway was involved in the above process was explored else. Methods Mouse MC3T3-E1 cells were culturedwithvariousconcentrationsofglycatedLDL(glycatedLDLlevelwas2.4%,5.3%,8.7%,13.9%)for24, 48, 72 h. Proliferation of MC3T3-E1 cell was measured by CCK-8, the osteocalcin level in the medium was determined by ELISA and the expression of LRP5 mRNA, DKK1 mRNA was measured by realtime PCR. Results After cells being incubated with 5. 3% of glycated LDL for 24 h, the inhibition of MC3T3-E1 cells was more marked than that in control group(P<0. 01). The higher glycated LDL level, the severer the inhibition. The effect of LDL on the MC3T3-E1 cell proliferation was time- and dose-dependent under certain conditions. Osteocalcin level in cell culture fluid with glycated LDL was lowered significantly compared with control group. Meanwhile, the expression of DKK1 mRNA was increased significantly but expression of LRP5 mRNA decreased (P<0. 01) in MC3T3-E1 cells cultured with 5. 3% of glycated LDL for 24 h. Conclusions Proliferation and differentiation of the osteoblasts in mice can be inhibited significantly by glycated LDL. The possible mechanism in the role played by glycated LDL on the proliferation and differentiation in MC3T3-E1 cells seems to be related to expression of LRP5 mRNA, DKK1 mRNA in the Wnt signaling pathway.

Objective:To analyze risk factors for acute cerebral infarction(ACI)combined with hyponatremia in patients aged 70 years and older, in order to improve clinical effects of integrated treatment.Methods:From Jan 2017 to Sep 2018, 324 ACI patients aged 70 years and older admitted to the neurology department of our hospital were enrolled.According to serum sodium levels, patients were divided into the normal serum sodium group(NG, n=284)and the hyponatremia group(HG, n=40). Patients in the HG group were further divided into the mild-to-moderate hyponatremia subgroup and the severe hyponatremia subgroup.Multivariate Logistic regression analysis was used to identify the correlation between risk factors for hyponatremia and prognosis.After one month of treatment, prognosis was assessed by using the Neurological Deficit Score(NDS).Results:There were significant differences between the NG and HG groups in age, the National Institutes of Health Stroke Scale(NIHSS)score, drinking, living alone, long-term bed rest, serum levels of C-reactive protein(CRP), D-dimer, fibrinogen(FIB), total cholesterol(CHOL), triglycerides(TG), high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C), total protein(TP), albumin(ALB), uric acid(UA), apolipoprotein A-1(Apo-A1), potassium, calcium, and phosphorus( P<0.05). Multivariable Logistic regression analysis showed that age( OR=0.917, 95% CI: 0.874-0.962, P=0.000), NHISS score on admission( OR=0.869, 95% CI: 0.783-0.964, P=0.008), drinking( OR=8.001, 95% CI: 3.864-16.567, P=0.000), living alone( OR=0.352, 95% CI: 0.204-0.608, P=0.000), serum CRP( OR=0.975, 95% CI: 0.960-0.990, P=0.001), D-dimer( OR=0.007, 95% CI: 0.001-0.053, P=0.000), CHOL( OR=1.268, 95% CI: 1.058-1.521, P=0.010)and LDL-C( OR=0.357, 95% CI: 0.230-0.552, P=0.000)were independent risk factors, and UA( OR=1.017, 95% CI: 1.013-1.021, P=0.000)was an independent protective factor for ACI combined with hyponatremia in patients aged 70 years and older.Patients in the NG group had better therapeutic effects and prognosis than those in the HG group( P<0.01). Conclusions:Elderly ACI patients aged 70 years and older are prone to hyponatremia.For better clinical effects of integrated treatment, electrolytes should be regularly monitored in elderly patients with related risk factors.

Purpose/Significance Based on the typical use scenario of sensitive personal information in medical and health institu-tions,the implementation of the secure use of sensitive personal information is explored.Method/Process For user registration,internal utilization and interaction,medical device/wearable device collection and information disclosure and other scenarios,the paper analyzes the risk of sensitive personal information leakage,explores the application scenarios,advantages and disadvantages of various technical means such as identity authentication,access control,data encryption,data desensitization and detection audit.Result/Conclusion The application of technical means can assist medical and health institutions to further protect the security of patients'personal information.

Objective:To investigate the relationship between adiponectin (ADIPOQ) gene polymorphism and postpartum type 2 diabetes mellitus (T2DM) in pregnant women with gestational diabetes mellitus (GDM).Methods:A retrospective study was conducted on 236 GDM postpartum women admitted to the Affiliated Hospital of Jining Medical College from June 2020 to June 2021 as observation subjects. They were divided into a T2DM group and a non T2DM group based on the occurrence of T2DM after delivery. The clinical data of the two groups were compared. The double deoxygenation end termination method was used to detect the single nucleotide polymorphism (SNP) of the ADIPOQ gene, and the four loci rs17366568, rs822395, rs1501299, and rs2241766 were classified. The relationship between ADIPOQ genotype polymorphism and postpartum T2DM was analyzed using a logistic regression model.Results:The G allele carrying the rs2241766 locus in ADIPOQ gene was negatively correlated with the occurrence of T2DM ( OR=0.71, 0.68, P<0.05). Compared with T2DM patients with TT genotype, the GT+ GG genotype at the rs2241766 locus had a lower risk of occurrence for gestational age ≥2 and HbA 1c>85%. Similarly, T2DM patients with pre pregnancy body mass index (BMI)>25 kg/m 2 were more likely to be carriers of the rs2241766 TT genotype ( P=0.026). The (GT+ TT) genotype carrying the T allele at the rs1501299 locus was a protective factor for gestational age and HbA 1c in T2DM patients. Conclusions:The rs2241766 and rs1501299 polymorphisms of the ADIPOQ gene are associated with susceptibility to postpartum T2DM in GDM women. Individuals with rs2241766 and rs1501299 mutant genotypes belong to the high-risk population for T2DM.

From September to October 2018, a questionnaire survey was conducted on the status of diabetes management, basic equipment allocation, complication screening and follow-up, basic drug supply and health education among 136 grassroots institutions in Nanjing. Doctors in the 136 grassroots institutions who had received diabetes specialist training accounted for 18.2% (358/1 968) of total general practitioners. The management rate of diabetes patients was 98.67% (196 352/199 000) , and the standard management rate was 88.63%(174 024/196 352).The screening and follow-up rates of diabetic complications were 89.0%(121/136) and 61.2%(74/121) for glycosylated hemoglobin; 64.7%(88/136), 58.0%(51/88) for urine microalbumin;51.5% (70/136), 62.9%(44/70) for diabetic foot; 44.9%(61/136), 42.6%(26/61) carotid ultrasonography; 32.4%(44/136) and 59.1%(26/44) for fundus examination; 17.6%(24/136) and 33.3%(8/24) for ankle brachial index. The rates of screening for glycosylated hemoglobin, urinary microalbumin, diabetic foot, carotid B ultrasound, fundus and ankle brachial index in urban areas were significantly higher than those in the suburbs (both P<0.05). The diabetes health education was regularly conducted in 92.0%(126/136) of grassroots institutions. At present, the grassroots institutions in Nanjing have established health archives for most diabetic patients and conducted health education regularly, but the professional training and the screening of diabetic complications need to be strengthened.