A total of 105 patients with ketosis-onset diabetes were divided into four groups (A+B-,A + B +,A - B -,A - B +) based on the results of islet-associated autoantibodies (A +,A - ) and β-cell function (B +,B - ).Nearly 94％ patients in the A -B + group and 1/10 patients in the A - B - group were non-insulin dependent.While in the A + B - and A + B + groups,the detection rates of subsequent non-insulin dependency were 20％ and 58％,respectively.Among the four groups,patients in the A - B + groups had a lower level of IL-6 and a higher level of TNF-α. Patients in the A + B - and A + B + groups had a higher level of IL-18.Our study indicates that patients with ketosis-onset diabetes may present different clinical characteristics. Evaluate the islet-associated autoantibodies and pancreatic β-cell function may be helpful to the clinical diagnostic and therapeutic strategies in diabetes.

Background:In recent years, the incidence of ulcerative colitis (UC) has increased year by year in China, and the number of elderly patients with UC is growing significantly.However, the difference in clinical characteristics between elderly and non-elderly UC patients was not fully clarified.Aims:To investigate the difference in clinical characteristics between elderly and non-elderly UC patients.Methods:A total of 163 UC patients admitted from Jan.2012 to Jun.2015 at the Affiliated Jiangyin Hospital of Southeast University Medical College were retrospectively recruited and divided into elderly group (no less than 60-year-old, n=32) and non-elderly group (less than 60-year-old, n=131) according to the age of onset.The clinical data were collected, and the general conditions, clinical manifestations and extent of the disease were compared between the two groups.Results:There were no significant differences in gender, family history of inflammatory bowel disease, history of smoking and appendectomy between elderly and non-elderly groups (P>0.05).Hematochezia and mucous bloody stool were less prevalent in elderly group than in non-elderly group (P<0.05), and the prevalence of abdominal pain, diarrhea and weight loss was comparable between the two groups (P>0.05).More extraintestinal manifestations were seen in non-elderly group, but the difference was not statistically significant (P>0.05).Lesions in elderly group mainly located in left hemicolon, while pancolitis was predominant in non-elderly group (P<0.05).Conclusions:In elderly patients with UC, hematochezia and mucous bloody stool are not frequently seen, and the disease is not extensive and mainly located in left hemicolon.

Objective:To investigate the effects of icaritin(ICT)on the proliferation and osteogenic differentiation of rat bone mar-row stromal cells(rBMSCs).Methods:rBMSCs were cultured from the bone marrow of SD rats and identified by multilineage differ-entiation assays.3,6 and 9 days after the treatment of rBMSCs of passage 4 by ICT at 1 0 -9 ,1 0 -8 ,1 0 -7 ,1 0 -6 and 1 0 -5 mol/L re-spectively,the proliferation and differentiation of the cells were examined by cck-8 and alkaline phosphatase (ALP)activity assay kit respectively.The calcium nodule formation was observed by alizarin red(AR)staining 21 days after 1 0 -9 mol/L ICT treatment. Results:Primary rBMSCs showed the typical spindle-like shape with attachment growth.rBMSCs could be induced to osteogenic and adipogenic differentiation.The proliferation of rBMSCs was inhibited but ALP activity was enhanced by ICT.1 0 -9 mol/L ICT in-cresed calcium nodule formation.Conclusion:ICT can dose-dependently inhibit the proliferation,but promote the osteogenic differ-entiation of rBMSCs.

Objective This study was aimed to characterize the swine leukocyte antigen( SLA) class I genes of GGTA1 -/ - Wuzhishan minipigs and compare their similarity to human leukocyte antigen( HLA) . It has important implica?tions for understanding the cellular rejection in xenotransplantation. Methods Specimens of ear tissue from six founding GGTA1 -/ - Wuzhishan minipigs were collected, and the SLA class I genes (SLA?1, SLA?3, SLA?2) were amplified by RT?PCR. Purified products were cloned into pEASY?T1 vectors and sequenced, followed by BLAST alignment and using bioin? formatc analysis to characterize the SLA class I genes and compare with the similarity to HLA. Results A total of six al?leles were detected, among them alleles were previously reported (SLA?1?0703,SLA?2?1102, SLA?3?0401, SLA?3?0403), and the other were novel (SLA?1?0401wz01, SLA?2?11wz01). The homology between alleles of SLA class I genes in Wuzhishan minipigs and HLA was from 70?5% to 72?1%. The homology analysis of critical amino acid residues on HLA binding with human CD8 + molecules showed that SLA?1?0401wz01, SLA?1?0703, SLA?2?11wz01, SLA?2?1102 and SLA?3?0401 occurred mutant at amino acid positions 225 and 228 ( T→S,T→M) , whereas the other loci were highly conserved. There was a high homology at amino acid level between SLA?2?11wz01, SLA?2?1102 and HLA class I genes which are NK cell KIRs binding sites. Conclusions The amino acid sequences of SLA class I genes of GGTA1 -/ -Wuzhishan minipigs have a high homology to HLA. From the point of view of cell?mediated xenograft rejection, the amino acid sequences of SLA class I genes of GGTA1 -/ - Wuzhishan minipigs have a high homology to HLA, therefore, Wzhishan minipigs may become a good potential donor for pig?human xenotransplantation.

Objective To observe the influence on early blood glucose by 3 L fluid replacementafter kidney transplantation. Methods Patients(60 cases) after kidney transplantation were randomly di-vidod into two groups.Group A used circular fluid replacement and Group B used 3L fluid replacement. Thelevel of blood glucose was detected before operation,after operation ,once every 8 hours at the first day,thenonce a day for the following six days. Results The level of blood glucose with 3 L fluid replacement waslower than that with circular fluid replacement,especially from the fast day to the fourth day after operation(P < 0.05). Conclusions The method with 3 L fluid replacement surpasses obviously circular fluid re-placement in blood glucose control after kidney transplantation.

Objective To investigate the protective and cure effects of dexamethasone on bleomycin-induced pulmonary fibrosis.Methods32 rats were randomly divided into the control group (C-group, n=8), injury group (I-group, n=12) and dexamethasone group (D-group, n=12). The acute pulmonary model was established by intratracheal injection of bleomycin with rats of the I-group and D-group; while rats of the C-group injected with distilled water. After that, rats of the D-group were injected with dexamethasone sodium phosphate in intraperitoneal every day, those of the C-group and I-group were injected with saline. The animals were killed on the 3rd, 7th, 14th, and 27th days after treatment, and tests of bronchoalveolar lavage fluid (BALF), total lung collagen content and lung tissue processing were performed.ResultsPathological evidence of the I-group rats demonstrated that the alveolar compartment companied with massive inflammatory cell invasion and a number of myofibroblast proliferation became more thick. However, lung injury in the D-group rats got better than that in the I-group. Neutrophil percentage achieved peak in both I-group and D-group on the 7th day. But the neutrophil ratio in the D-group was significantly lower than that of the I-group on the 7th day ( P<0.05) and the 14th day ( P<0.01). Total lung collagen content achieved peak on the 14th day both in I-group and D-group, but that of the I-group was significantly higher than that of the C-group ( P<0.01) and the D-group was significantly lower than the I-group ( P<0.01).ConclusionDexamethasone plays a protective and cure role in lung fibrosis by efficiently inhibiting the gather and invasion of neutropils and restraining the increase of collagen secreted by proliferous fibroblasts.

Objective To investigate the association between serum estradiol levels and macrovascular complication of atherosclerosis in mid-aged and elderly male patients with type 2 diabetes mellitus(T2DM).Methods One hundred and twenty nine male diabetic patients aged over 45 years were recruited in this study.Serum estriol(E2), testosterone(T)and lipid levels were detected using chemiluminescent immunoassay.Carotid ultrasonography was taken to evaluate macrovascular complication of atherosclerosis.The demographic characteristics, clinical features including duration of diabetes and prevalence of carotid atherosclerosis and biochemical features were compared among patients with different serum E2levels.Correlation analysis was also performed using binary logistic analysis.Results There were 43 patients with low serum E2level(<134.1 pmol/L), 44 with intermediate E2level(134.1 -198.2 pmol/L)and 42 with high E2level(>198.2 pmol/L).Among 129 patients the carotid artery lesions were detected in 64 cases.There were significant differences in body weight[(61.0 ±10.4), (67.4 ±13.0)and(76.8 ±10.5)kg,t=3.40,P=0.00], waist circumference[(81.5 ±7.9),(86.6 ± 10.7)and(90.0 ±8.0)cm,t=3.57,P=0.00],body mass index(BMI)[(21.6 ±3.2),(23.5 ±3.8) and(26.2 ±3.0)kg/m2,t=3.72, P=0.00], systolic pressure[(140.2 ±14.8),(143.9 ±18.1)and (155.0 ±13.1)mmHg(1 mmHg=0.133 kPa),t=3.18, P=0.04]and TG[(1.46 ±0.88),(2.23 ± 1.08)and(3.35 ±0.9)mmol/L, t =2.66, P=0.04]among patients with low, intermediate and high serum E2levels.The age-adjusted incidence of carotid atherosclerotic plaque in patients with low, intermediate and high E2levels were 25.6%(11/43),56.8%(25/44)and 66.7%(28/42), respectively (χ2=15.73,P=0.00).Compared to low E2level,the risk ratio of carotid atherosclerosis in intermediate and high E2levels was 1.60(95%CI:1.04-2.46, P<0.05)and 1.80(95%CI:1.17 -2.76, P<0.05),respectively.Conclusion Serum E2level is closely associated with carotid atherosclerotic plaque in middle-aged and elderly male type 2 diabetic patients.

The English curriculum in medical university can include English for general purpose (EGP), English for medical academic purposes (EMAP) and English for medical occupational purposes (EMOP). Teachers can dig deeply the medical humanities elements in the teaching materials, enrich the medical humanities knowledge and expand the medical terms. Combining production-oriented approach (POA) and online course, the teachers set up study groups, design medical scenarios, assign production tasks and carry out flipped classroom teaching practice. The three stages of POA, motivating, enabling and assessing, can organically connect pre-class, in-class and after-class. This model can cultivate effectively the medical students language competency, critical thinking ability and cooperative ability and improve their humanistic quality, and at the same time, it also poses higher requirements and challenges for front-line English teachers and students.

Objective: Based on observational, longitudinal and intervention study of common diseases among students in Jiangsu Province, this paper presents the current progress of two year follow up of myopia cohort regarding the association between growth parameters with progression of myopia among children and adolescents in areas with rapid economic growth. Methods: This survey adopted the stratified cluster sampling method for school selection. The full automatic computer optometry (TOPCON RM800) was used to track myopia related parameters for all participants from 2019 to 2020 under the condition of mydriasis (compound topicamide eye drops). Relationship between growth parameters of children and adolescents and the incidence and progression of myopia was analyzed by using Cox regression multiple statistical model. Results: The myopia rates of students from grade 1 to grade 3 in 2019 were 5.4%, 21.5% and 37.3% respectively. After one year, the myopia rates of all school stages increased to 25.3%, 43.3% and 58.1% respectively( χ 2=53.59, 49.63, 32.52, P <0.01). The mean diopter of right eye and left eye after mydriasis were ( 0.30± 1.24/0.39±1.26)D in 2019 and (-0.33±1.54/-0.19±1.55)D in 2020, respectively based on Cox multiple regression results, age ( HR =1.21, 95% CI =1.09-1.34), naked eye vision ( HR =0.08, 95% CI =0.07-0.11), height ( HR =0.98, 95% CI =0.97-0.99) showed a strong correlation with the incidence and progression of myopia( P <0.05). Conclusion Myopia is growing rapidly in the central region of Jiangsu Province. It is suggested that diopter, axial length, naked eye vision, age, height and other indicators should be included in the refractive archives of children and adolescents in the region.

Objective: To investigate the prevalence of reproductive system diseases among female workers in a city and related occupational influencing factors. Methods: From June to September, 2016, a cross-sectional survey was used to select 9 944 female workers from six districts of Beijing and then a face-to-face questionnaire survey was performed. Univariate analysis using chi-square test and multivariate logistic regression analysis were used to investigate the risk factors for reproductive system diseases. Results: The age of 9944 female workers ranged from 18 to 65 years (mean 35.53±9.52 years) , and among them, 7 351 (73.92%) were married. The overall prevalence rate of reproductive system diseases among these 9944 female workers during the past three months was 28.29%, and the prevalence rates of hyperplasia of mammary glands, vaginitis, and hysteromyoma were 15.54%, 11.25%, and 6.77%, respectively. After adjustment for age, marital status, education level, and annual family income, the multivariate logistic regression analysis showed that frequent overtime work (odds ratio[OR]=1.119, 95% confidence interval[CI]: 1.070-1.343) , frequent night shifts (OR=1.198, 95%CI: 1.054-1.361) , standing for a long time (OR=1.197, 95%CI: 1.063-1.347) , sitting for a long time (OR=1.327, 95%CI: 1.191-1.479) , heavy workload (OR=1.429, 95%CI: 1.262-1.615) , exposure to lead (OR=1.696, 95%CI: 1.307-2.201) , exposure to mercury (OR=1.452, 95%CI: 1.086-1.940) , and exposure to ionizing radiation (OR=1.679, 95%CI: 1.424-1.980) were associated with reproductive system diseases. Conclusion The prevalence of reproductive system diseases among female workers in Beijing is not optimistic. Reproductive system diseases are associated with frequent overtime work, frequent night shifts, standing for a long time, sitting for a long time, heavy workload, and exposure to lead, mercury, and ionizing radiation.