Objective To explore the impacts of subclinical hypothyroidism (SCH) on chronic complications of type 2 diabetes mellitus. Methods Totally 448 patients with type 2 diabetes were divided into diabetes plus SCH group (n=148) and control group (T2DM without SCH,n=300).The patient's general information,past medical history,chronic complications of diabetes including diabetic nephropathy ( DN ), diabetic retinopathy ( DR), diabetic peripheral neuropathy ( DPN ),peripheral arterial disease (PAD),diabetic foot (DF),ancillary and laboratory test results were analyzed. Results The age,duration of diabetes,incidence of coronary heart disease and levels of fasting C-peptide,total cholesterol,triacylglycerol,lipoprotein (a),hs-CRP,LDL-C,UAER and thyroid stimulating hormone (TSH) [(6.8 ± 3.5) mIU/L vs. (2.1 ± 1.3) mlU/L], antithyroidperoxidase antibody (TPO-Ab) [(253.6 ± 287.1 ) kU/L vs. (46.2 ± 80.7)] kU/L and thyroglobulin antibodies (TG-Ab) [( 57.8 ± 83.5 ) kU/L vs. ( 39.4 ± 45.3 ) kU/L] were significantly higher,but the ankle brachial index(ABI) and E/A value were lower in diabetes plus SCH group than in control group (P＜0.01 or 0.05).The prevalences of DN( 63％ vs.46％,P＜0.01),DR (40％vs.29％,P＜0.05),DPN (34％ vs.24％,P＜0.05),PAD (51％ vs.38％,P＜0.05) and DF (22％ vs.12％,P＜0.01) were higher in diabetes plus SCH group than in control group.Logistic regression analysis demonstrated that high level of TSH was independent risk factor for DN(β=0.1273,OR =1.1361) and DF (β=0.1153, OR =1.1222). Conclusions Subclinical hypothyroidism is an independent risk factor for diabetic nephropathy and diabetic foot,so the elderly with longer duration of diabetes should regularly be checked in thyroid ffunction to early find hypothyroidism.

Objective To investigate treatment effect of the type of foot drop in patients with lumbar disc herniation.Methods Clinical data of 34 patients with foot drop in lumbar disc herniation who were treated in Spinal Surgery Department of Shunyi District Hospital of Beijing from January 2006 to December 2013 were retrospective analyzed,all patients were treated by operation.After 24 months of follow-up,the effect was observed,the prognosis and related factors were analyzed.Results Two years after operation,the recovery of the patients was excellent in 4 cases and good in 19 cases,common and poor in 11 cases,and the excellent and good rate was up to 67.6%(23/34).Analysis results showed that after 3 to 24 months after surgery,the anterior tibial muscle strength grades(grade 0-5) corresponding score were 28 points preoperatively,59 points at 3 months after surgery,69 points at 6 months after surgery,92 points 1 year after surgery,reached 95 points 2 years after surgery.Muscle strength score of patients with an increasing trend,especially after 3 months to 12 months after the operation.Conclusion The drop occurred should be operated as soon as possible,recommendations for open surgery,complete decompression,avoid injury.Three months to 1 years after operation is the key period of recovery.

AIM: To investigate the role of fluoxetine in the hippocampal synaptic plasticity in chronic unpre-dictable mild stress (CUMS) depression rats and its effect on mTOR and autophagy signaling pathways.METHODS:Male Sprague-Dawley rats (n =60) were randomly divided into normal control group, CUMS group and fluoxetine group. The CUMS rat model was established through CUMS combined with solitary raising, and fluoxetine (20 mg? kg -1? d -1 ) was administered via intragastric gavage.The changes of body weight, the ratio of sugar intake and the results of the behav-ioral test were recorded to identify the modeling.Moreover, the expression of synaptic plasticity-related proteins glial fibril-lary acidic protein (GFAP) and synaptophysin (SYP), apoptosis-related proteins Bcl-2 and caspase-3, mTOR signaling proteins mTOR and 4EBP1, and autophagy-related proteins beclin 1 and LC3 were examined by RT-PCR and Western blot. RESULTS: Compared with control group, the body weight, sucrose intake, and total distance and intermediate residence time in the open field test were significantly decreased in CUMS group.The results of RT-PCR and Western blotting showed that the mRNA and protein levels of SYP and GFAP in CUMS group were significantly down-regulated compared with con-trol group.The expression of Bcl-2 in CUMS group was downregulated, while the protein level of cleaved caspase-3 in-creased.Decreased phosphorylation levels of mTOR and its downstream target molecule 4EBP1 were observed in CUMS group.Besides, the autophagy-related proteins beclin 1 and LC3 were significantly upregulated at mRNA and protein lev-els.All these results(upregulation or downregulation) were attenuated by the treatment with fluoxetine, and the difference was statistically significant.CONCLUSION: Fluoxetine might improve hippocampal synaptic plasticity and alleviate symp-toms of depression by supressing apoptosis/autophagy signaling pathways and upregulating mTOR signaling pathway.

Objective:To explore the torque effect of controlling root auxiliary arch on the straight wire appliance on maxillary anterior teeth.Methods:22 patients with class Ⅱ1 extraction treatment,treated with straightwire appliance,at the detailing treatment stage were treated with controlling root auxiliary arch over the erect or introverted maxillary incisors for positive torque.The main arch wire of 0.46 mm ×0.64 mm stainless steel edge wire was used in 14 cases,the main arch wire of 0.46 mm stainless steel round wire was used in 8 cases.Cephalometric results before and after maxillary incisor torque were analyzed by t test.Results:After maxillary incisor torque in the 22 cases 1-SN and UIa-NA value increased(P ＜0.01),positive torque was achieved by controlling root auxiliary arch on the upper incisors;the round wire maxillary incisor torque worked faster than the edge wire(P ＜0.05).Conclusion:At the detailing stage of treatment straight wire appliance on front teeth,controlling root auxiliary arch is simple and effective in the treatment of exces-sive erect or lingual inclination of maxillary incisor.

Objective To explore the sensitivity of using NT,combined with serum biochemical markers (Free-βhCG,PAPP-A) for Down's Syndrome screening in early stage of pregnancy.Methods Collect pregnant women aged 17-45 years old voluntary antenatal screening in our hospital from March 2009to October 2010,a total of 11882 cases.Serum Free-βhCG and PAPP-A were measured NT value was determined by ultrasound at 11-13w+64 of gestation.Calculating combined screening (NT,Free-βhCG,PAPP-A),and serum integrated screening (Free-beta hCG,PAPP-A) risk,respectively,using the risk calculation software for the same person.Results Early pregnancy screening was performed in 11 882patients,18 had a fetus with Down's syndrome,a rate of 0.15％.The detection rates of Down's syndrome in combined screening and serum integrated screening were 83.3％ and 72.2％ respectively.The specificities were 98.4％ and 97.3％ and detection efficiency were 7.18％,3.90％ respectively.Areas under the curve (AUCs) of fhst-trimester combined screening and serum integrated screening were 0.975 (95％ CI:0.943,1.007),0.901 (95％ CI:0.789,1.013) respectively.Conclusion In early stage of pregnancy,combined screening for Down's syndrome has higher sensitivity and specificity than serological screening,has higher detection rate in the same false-positive rate case,which can effectively reduce the pregnant women to receive invasive puncture.

HEV is a positive strand RNA virus containing 3 open reading frames(ORFs), while the function of its binding protein pORF3 is poorly understood. In our study, the interactive protein of the pORF3 from human liver cDNA library was screened by the SOS recruitment system, and the construction of the pSOS bait-ORF3 plasmid was identified. The expression of the pORF3 was analyzed by Western blotting, and the detection result of the self activation of bait protein was obtained as expected. Totally, 8 putative interacting proteins had been successively screened. Some of these cellular binding proteins of pORF3, especially the important immunological pathway kinase p110δ, may advance our understanding of the role in ORF3 protein of HEV, and the possible implications of these candidate proteins for the further research are discussed.

Abstract: Objective To explore the dynamic characteristics of stigmatization in HIV/AIDS patients and provide scientific evidence for psychological care. Methods HIV/AIDS patients receiving antiretroviral therapy (ART) treatment in Nanning Fourth People's Hospital were randomly selected for baseline and 1 year follow-up questionnaire survey including internalized HIV stigma, anticipated HIV stigma, exposure to HIV stigma. The differences between the two groups at different time points were dynamically compared to analyze the changing characteristics of stigma in HIV/AIDS patients. Results After one year of ART treatment, among the eight items of internalizing stigma, five items including the proportion of feeling ashamed of being infected with HIV/AIDS, feeling unclean because of being infected with HIV/AIDS, feeling inferior to others because of having HIV/AIDS, feeling guilty because of having HIV/AIDS, and having a poorer self-perception due to how others view HIV/AIDS decreased significantly from 34.0% to 43.5% at the baseline to 19.5% to 29.5%, showing significant improvement with statistical significance (χ2=18.586, 14.277, 10.473, 12.219, 9.934, P<0.05); among the nine items of anticipated stigma, four items including the proportion of community/community workers not taking my needs seriously, discriminating against me, refusing to provide services for me, and healthcare workers avoiding contact with me decreased significantly from 16.0% to 27.5% at the baseline to 7.0% to 15.5%, respectively, showing significant improvement with statistical significance (χ2=13.690, 15.787, 12.034, 12.593, P<0.05); among the 16 items of exposure to HIV stigma, six items including the proportion of experiencing physical attacks, psychological pressure from spouses/partners, being refused sexual relationships, losing jobs or other economic sources, being rejected or losing a job opportunity due to HIV/AIDS, changing job nature due to HIV/AIDS, or being refused medical services decreased significantly from 2.5% to 15.0% at the baseline to 1.0% to 8.0%, respectively, showing significant improvement with statistical significance (χ2=8.619, 15.558, 6.061, 9.049, 5.432, 8.156, P<0.05). Physical assaults on people with HIV/AIDS increased by 5.5 percent(χ2=5.368, P<0.05). Conclusions Through 1-year dynamic monitoring, 48.48% of the three dimensions of stigma of HIV/AIDS patients were alleviated. Treatment intervention, self-acceptance and the creation of a good non-discriminatory social environment have an important impact on the stigma of HIV/AIDS patients and deserve the attention of society as a whole.

Objective To investigate the effects of early sucking a lollipop and pacifier to improve the recovery of gastrointestinal function in infant after gastrointestinal operation. Methods The infants after gastrointestinal operation were divided into four groups according to the random number table method, namely group Ⅰ, Ⅱ, Ⅲ and Ⅳ. Four groups were given different interventions in addition to routine nursing care after anesthesia awake, group Ⅰsucked a lollipop,while groupⅡsucking pacifier. Intervention time of 2 groups were 20-30 minites. GroupⅢsucked the pacifier 20-30 minites first, then sucked a lollipop 20-30 minites. Each group was given one intervention every 4 hours until infant eated. Group Ⅳ was given no interventions. Bowel sounds recovery time, first bowel movement time for the first time were compared. SPSS 17.0 software was used for statistical analysis. Results A total of 82 infants completed the clinical observation. Bowel sounds recovery time of group Ⅰ,Ⅱ,Ⅲ were (28.54±9.93), (34.10±9.43), (28.50±9.52) h, while first bowel movement time were (50.02±11.60), (57.65±15.28), (49.97±15.46) h, which were earlier than group Ⅳ whose bowel sounds recovery time and first bowel movement time were (39.55 ±11.22) h, (65.43 ±14.78) h. The bowel movement time and first bowel movement time of group Ⅲ were earlier than that of groupⅡ (P<0.05), but groupⅠandⅢhad no obvious difference (P>0.05). Conclusions Infants early sucking a lollipop and pacifier after gastrointestinal operation help gastrointestinal function recovery, but the lollipop is superior to the pacifier, lollipops and no interaction between pacifier.

Objective To explore the relationship between sudomotor function and peripheral artery disease (PAD),and to evaluate the effectiveness of sudomotor function testing to screen diabetic patients at high risk of PAD comparing to ankle-brachial index (ABI) and toe-brachial index (TBI).Methods A total of 263 diabetes mellitus (DM) outpatients in the 306th Hospital of PLA from August 2014 to April 2015 were enrolled in the study.ABI and TBI were measured by the Doppler method.Sudomotor function was evaluated by measuring the electrochemical skin conductance (ESC) of the hands and feet using the Sudoscan instrument.Cardiovascular autonomic neuropathy (CAN) was assessed and recorded as cardiac autonomic neuropathy risk-score (CAN-RS) by Sudoscan.Results ESC values of the feet and hands were positively correlated with ABI and TBI.The diabetes patients with abnornal ABI and TBI had significantly lower hand ESC [(45.63±12.87) μS vs.(68.10±17.40) μS,(59.17±19.58) μS vs.(68.57±17.11) μS;P＜ 0.05] and feet ESC [(44.54±25.48) μS vs.(70.92±19.46) μS,(59.21±24.52) μS vs.(71.71±19.02) μS;P＜ 0.05],and higher CAN-RS[(49.17± 15.41)％ vs.(36.33±16.25)％,(44.90±16.09)％ vs.(35.39±16.05)％;P＜ 0.05],than diabetes patients with normal ABI and TBI.Using ABI as the gold standard,the areas under the receiver operating characteristics (ROC) curve of the diagnostic performance of hands ESC,feet ESC and CAN-RS to identify PAD were 0.87,0.84 and 0.74,respectively (P＜0.001).Conclusion Sudomotor function testing can be helpful and beneficial to identify PAD in patients with diabetes.

Objective To explore the diagnosis of cystinosis.Methods The clinical and biochemical information, and gene detection results in a child with cystinosis was retrospective analyzed.Results Four-year-old female presented with photophobia and corneal crystal was found by ophthalmic examination at 2 years old, bilateral kidney stone was found, accompanied by development delay and rickets at 3 years old. Gas chromatography analysis in urine showed that a variety of amino acids were increased, and urine sugar and urinary micro-protein were also increased, which were in accordance with fanconi syndrome. The blood free carnitine was decreased, ester acyl carnitine spectrum was normal, and multi-amino acids such as lysine, valine and arginine were decreased. Gene analysis showed a homozygous mutation of c.696C>G (p.323 N>K) inCTNS gene, which was a known mutation. Both her parents were carrier of heterozygous mutation of c.696C>G inCTNS gene.Conclusion Child with kidney stone, renal damage, combined by multi-system damage such as eyes, bone, and thyroid should be paid attention to identify the cystinosis.