Objective To study the effect of the polymorphism of (AC) n of aldose reductase (AR) gene on the erythrocyte AR activity in type 2 diabetes mellitus (DM). Methods One hundred and sixty three cases of type 2 DM and forty two controls were included in this study. The subjects were devided into DM without diabetic microangiopathy (DMAP) (NDC) (66 cases), DMAP groups (97 cases), and normal controls (CON) (42 cases); further, according to the type of allele, the subjects were devided into DM with Z+2 (DZ+2) (54 cases), DM with Z-2 (DZ-2) (35 cases), DM with both Z+2 and Z-2 (Z+2/Z-2) (18 cases), DM with neither Z+2 nor Z-2 (X/X) (56 cases), non DM with Z+2 (NZ+2) group (21 cases) and non DM with Z-2 (NZ-2) groups (7 cases). AR activity (ARA) was measured by modified Sriratava method. The differences of ARA were compared among these groups. Results ARA in DMAP group was significantly higher than that in NDC group, ARA in NDC group was significantly higher than that in CON group. Among DZ-2, DZ+2, Z+2/Z-2 and X/X groups, ARA was the highest in DZ-2 group and the lowest in DZ+2 group. ARAs in DZ-2 and NZ-2 groups were significantly higher than those in DZ+2 and NZ+2 groups respectively. In DZ-2 and DZ+2 groups ARA was significantly higher than that in NZ-2 and NZ+2 groups respectively. Conclusion The activation of AR plays an important role in the development of DMAP. Z-2 allele may be an activator and Z+2 allele may be an inhititor of AR.

Diabetic KK-Ay mice were given glimepiride (GM) and glibenclamide (GB). After treatment, the visceral white fat content, insulin and hypothalamic neuropeptide Y (NPY) levels were significantly lower in GM group than those in GB group, suggesting that in addition to the lower insulin level stimulated by GM, the lower concentration of hypothalamic NPY seems to play a role in lessening increase in body fat of type 2 diabetic animals treated with GM.

This study assessed the effects of leukemia-related protein 16 (LRP16) on the regulation of pancreatic functions in mouse insulinoma (MIN6) cells. Cells with down-regulated expression of LRP16 were obtained by a shRNA interference strategy. Insulin content and glucose-stimulated insulin secretion (GSIS) were examined by radioimmunoassay. Western blotting was applied to detect protein expression. Glucose-stimulated sub-cellular localization of PDX-1 was immunocytochemically determined. Cell proliferation and apoptosis were detected by flow cytometry. Our results showed that LRP16 regulated insulin content in MIN6 cells by controlling expression of insulin and insulin transcription factors. LRP16 gene silence in MIN6 cells led to reduced cell proliferation and increased apoptosis. The observation of phosphorylation of serine-473 Akt and the localization of PDX-1 to the nucleus under glucose-stimulation exhibited that LRP16 was a component mediating Akt signaling in MIN6 cells. These results suggest that LRP16 plays a key role in maintaining pancreatic β-cell functions and may help us to understand the protective effects of estrogen on the functions of pancreatic β-cells.

Objective:To understand the epidemiological characteristics and pathogenic spectrum of influenza-like illnesses in Tianjin Children′s Hospital from October 2020 to March 2021, and to provide reference for the prevention, control and clinical diagnosis and treatment of influenza-like illnesses.Methods:A total of 520 throat swabs samples were collected from patients with influenza-like illnesses in sentinel hospitals. Thirty respiratory tract pathogens were detected by real-time fluorescence quantitative PCR. The results were statistically analyzed by descriptive epidemiological methods.Results:Among the 520 samples, 239 were positive for 16 respiratory pathogens with a positive rate of 45.96%. The top three pathogens were respiratory syncytial virus (9.62%, 50/520), rhinovirus (9.62%, 50/520) and cytomegalovirus (5.96%, 31/520). The positive rate of respiratory pathogens was 49.67% in males and 40.91% in females and the difference between males and females was statistically significant (χ 2=3.919, P<0.05). There were significant differences in the positive rates among three age groups (χ 2=6.182, P<0.05) with the highest positive rate in the <2 years old group (52.91%, 91/172) and the lowest rate in the >4 years old group (38.10%, 40/105). There were significant differences in the positive rates detected in different months (χ 2=15.358, P<0.05) and the highest detection rate was in December (58.00%, 58/100), followed by those in November (52.50%, 42/80) and January (47.50%, 38/80). The multiple infection rate was 21.76% (52/239) and most of the multiple infections were caused by rhinovirus and other pathogens (48.08%, 25/52). Conclusions:Respiratory syncytial virus, rhinovirus and cytomegalovirus were the predonimant pathogens responsible for influenza-like illnesses in Tianjin Children′s Hospital from October 2020 to March 2021. Multiple infections were common and children under 2 years old were more susceptible. The detection rate of respiratory pathogens varied in different months. It was necessary to strengthen the surveillance and research on those respiratory pathogens in order to provide scientific data for the prevention and control of respiratory diseases in children.

This study assessed the effects of leukemia-related protein 16 (LRP16) on the regulation of pancreatic functions in mouse insulinoma (MIN6) cells.Cells with down-regulated expression of LRP16 were obtained by a shRNA interference strategy.Insulin content and glucose-stimulated insulin secretion (GSIS) were examined by radioimmunoassay.Western blotting was applied to detect protein expression.Glucose-stimulated sub-cellular localization of PDX-1 was immunocytochemically determined.Cell proliferation and apoptosis were detected by flow cytometry.Our results showed that LRP16 regulated insulin content in MIN6 cells by controlling expression of insulin and insulin transcription factors.LRP16 gene silence in MIN6 cells led to reduced cell proliferation and increased apoptosis.The observation of phosphorylation of serine-473 Akt and the localization of PDX-1 to the nucleus under glucose-stimulation exhibited that LRP16 was a component mediating Akt signaling in MIN6 cells.These results suggest that LRP16 plays a key role in maintaining pancreatic β-cell functions and may help us to understand the protective effects of estrogen on the functions of pancreatic β-cells.

Objective To compare the difference of cutpoint and clinical significance of HbA1C for the diagnosis of abnormal glucose metabolism in two population groups with different ages.Methods According to oral glucose tolerance test(OGTT),the cutpoint and clinical significance of HbA1C for the diagnosis of type 2 diabetes and impaired glucose regulation(IGR)were investigated in the two population groups.Results The mean HbA1C of 1 064 young subjects in an academy and 1 671 aged subjects in a community were 5.31% ±0.41% and 5.79% ±0.71%,respectively.The cutpoints of HbA1C for diagnosis of diabetes were 5.7%(specificity 86.7%,sensitivity 66.7%)and 5.9%(specificity 73.8%,sensitivity 80.1%)in the two population groups,and 5.6% for diagnosis of IGR (specificity 82.8%,sensitivity 55.8%)and 5.7%(specificity 60.9%,sensitivity 64.3%),respectively.87.8%,78.7%,and 38.5% were diagnosed diabetes by current OGTT criteria at HbA1C levels of ≥5.7%,≥5.9%,and≥6.5%,IGR being 61.6%,39.6%,and 4.1%,and normal glucose tolerance being 24.4%,10.0%,and 0.4%.Conclusion The cutpoints of HbA1C for diagnosis of diabetes and IGR are different in populations with different ages and HbA1C levels.As one of diagnostic criteria for diabetes,HbA1C 6.5% with relatively higher specificity and lower sensitivity must be combined with fasting blood glucose,random blood glucose,and OGTT.

OBJECTIVE：To investigate the anti-inflammatory activity of 70％ ethanol extracts from Garcinia oblongifolia （GOEE）on LPS-induced RAW 264.7 cells and its potential molecular mechanism. METHODS ：GOEE was obtained after the fresh G. oblongifolia epicarp refluxed with 70％ ethanol. The contents of total phenol and total flavonoids were determined by Folin-Ciocalteau assay and UV spectrophotometer. MTT assay was used to detect the cytotoxicity of different doses of GOEE. The inflammatory model was induced in RAW 264.7 cells by lipopolysa- ccharide （LPS）. Using dexamethasone and N-acetyl-L-cysteine as positive control ，Griess assay and 2′，7′-dichloro- fluorescein assay were used to detect the contents of NO in cell culture medium and ROS in cells. The levels of TNF-α，IL-6，and IL- 1β in cell culture medium were measured by ELISA. The protein expression of p 65，p-p65，IκBα，p-IκBα，HO-1 in cells and NRF 2 in nucleus were determined by using Western blotting assay. RESULTS：The contents of total phenol and flavonoids in GOEE were （20.191±1.264）and（12.571±0.020）mg/g，respectively. At the concentration below 500 μ g/mL， GOEE had no significantly effect on survival rate of RAW 264.7 cells（P＞ 294043）0.05）. Compared with control group ，the contents of NO and ROS，the levels of TNF-α，IL-6 and IL- 1β，ratio of p-p 65 top65，ratio of p-IκBα to IκBα，protein expression of NRF 2 were increased significantly in LPS model group （P＜0.05 or P＜0.01）. Compared with LPS model group ，the contents of NO（except for GOEE 50 μg/mL group）and ROS ，the levels of TNF-α，IL-6 and IL- 1β，ratio of p-p 65 to p 65 and ratio of p-IκBα to IκBα were decreased significantly in GOEE groups and positive control groups ，while protein expression of HO- 1 and NRF 2 were increased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS：GOEE attenuates LPS-induced macrophages inflammation injury by inhibiting the inflammatory response and the phosphorylation of NF-κB pathway，promoting NRF 2 protein transportation to the nucleus.

Objective To investigate the antimicrobial resistance profile of the clinical isolates collected from selected hospitals across China. Methods Twenty-nine general hospitals and five children's hospitals were involved in this program. Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems. Results were interpreted according to CLSI 2017 breakpoints. Results A total of 190 610 clinical isolates were collected from January to December 2017, of which gram negative organisms accounted for 70.8％ (134 951/190 610) and gram positive cocci 29.2％ (55 649/190 610). The prevalence of methicillin-resistant strains was 35.3％ in S. aureus (MRSA) and 80.3％ in coagulase negative Staphylococcus (MRCNS) on average. MR strains showed much higher resistance rates to most of the other antimicrobial agents than MS strains. However, 91.6％ of MRSA strains were still susceptible to trimethoprim-sulfamethoxazole, while 86.2％ of MRCNS strains were susceptible to rifampin. No staphylococcal strains were found resistant to vancomycin. E. faecalis strains showed much lower resistance rates to most of the drugs tested (except chloramphenicol) than E. faecium. Vancomycin-resistant Enterococcus (VRE) was identified in both E. faecalis and E. faecium. The identified VRE strains were mainly vanA, vanB or vanM type based on phenotype or genotype. The proportion of PSSP or PRSP strains in the non-meningitis S.pneumoniae strains isolated from children decreased but the proportion of PISP strains increased when compared to the data of 2016. Enterobacteriaceae strains were still highly susceptible to carbapenems. Overall, less than 10％ of these strains (excluding Klebsiella spp.) were resistant to carbapenems. The prevalence of imipenem-resistant K. pneumoniae increased from 3.0％ in 2005 to 20.9％ in 2017, and meropenem-resistant K. pneumoniae increased from 2.9％ in 2005 to 24.0％ in 2017, more than 8-fold increase. About 66.7％ and 69.3％ of Acinetobacter (A. baumannii accounts for 91.5％) strains were resistant to imipenem and meropenem, respectively. Compared with the data of year 2016, P. aeruginosa strains showed decreasing resistance rate to carbapenems. Conclusions Bacterial resistance is still on the rise. It is necessary to strengthen hospital infection control and stewardship of antimicrobial agents. The communication between laboratorians and clinicians should be further improved in addition to surveillance of bacterial resistance.

Background Healthcare workers suffer from great internal and external pressure and are prone to burnout. Existing studies have shown that depressive symptoms are important influencing factors of burnout, both of which are closely related to job stress. Objective To analyze overall prevalence of burnout among healthcare workers using a new survey tool developed by our team, and to reveal potential influencing factors related to burnout. Methods A cross-sectional multi-center study was conducted in August–October 2019 and June–September 2020, using multi-stage stratified cluster sampling. A total of 8738 healthcare workers from 22 hospitals in 5 provinces (Shandong, Hubei, Hunan, Guangdong, and Chongqing) of China were selected in this study. A set of survey questionnaires, including the general information questionnaire and the Chinese versions of General Burnout Scale, Core Occupational Stress Scale, Patient Health Questionnaire-9, and Self-administered Sleep Questionnaire were distributed. Independent samples t-test or one-way ANOVA were employed for inter-group comparison of burnout. Spearman correlation was used to evaluate correlations among burnout, depressive symptoms, and occupational stress. Stepwise linear regression was conducted to identify factors independently associated with burnout. Process plug-in was used to test potential mediating effect of depressive symptoms on occupational stress and burnout. Results Of the 8738 questionnaires distributed, 8456 valid questionnaires were collected, and the recovery rate was 96.77%. Among the 8456 healthcare workers, the prevalence of burnout was 58.0%, that of occupational stress was 31.8%, and that of depressive symptoms was 31.0%. Among those with depressive symptoms and occupational stress, the proportions of burnout were 86.7% and 83.7%, respectively. According to the stepwise linear regression analysis, depressive symptoms, occupational stress, work experience, drinking, and marital status were all independent influencing factors of burnout. Especially, depressive symptoms, social support, and organization and reward had significant influences on burnout (b'=0.455, −0.183, 0.220, P<0.001). Depressive symptoms showed mediating effects on occupational stress (and its subscales) and burnout, and the contribution rates of the mediating effects were 41.00%, 47.02%, 43.44%, 56.62%, and 59.45%, respectively. Conclusion Burnout is a prominent problem among healthcare workers in the 5 provinces, with the prevalence of 58.0%. And nearly 1/3 suffering from depressive symptoms and occupational stress, which has a great impact on burnout.