Objective To explore the correlation of neutrophil/lymphocyte ratio(NLR),monocyte/high density lipoprotein cholesterol ratio(MHR)and mild cognitive impairment(MCI)in patients with type 2 diabetes mellitus(T2DM).Methods 159 T2DM patients hospitalized in the Department of Endocrinology,Affiliated Hospital of Xuzhou Medical University from February 2023 to April 2023 were selected.The subjects were divided into normal cognitive function(Con,n=72)group and MCI group(n=87)based on score of Montreal cognitive assessment scale(MoCA).NLR and MHR were calculated and compared between the two groups.Spearman correlation analysis was used to analyze the correlation between NLR,MHR and MoCA score.Logistic regression analysis of the factors influencing the association between T2DM with MCI.Receiver operator characteristic(ROC)curve was used to evaluate the predictive value of NLR and MHR for DM complicated with MCI.Results Compared with Con group,MCI group showed a significant increase in hemoglobin A1c(HbA1c),fasting plasma glucose,NLR,MHR,neutrophil count,monocyte count,serum creatinine,cystatin C,while high density lipoprotein cholesterol lymphocytes,visual space and executive function,naming,attention,language ability,abstract thinking,delayed memory,orientation and MoCA score decreased(P＜0.05).Spearman correlation analysis showed that there was a negative correlation between MHR,NLR and MoCA score,visuospatial and executive function,delayed recall and attention.Logistic regression analysis showed that NLR,MHR,HbA1c were all risk factors for MCI in T2DM.ROC curve analysis showed that the area under the curve of NLR combined with MHR for diagnosing T2DM with MCI was 0.872,with corresponding sensitivity of 81.6%and specificity of 87.5%.Conclusions NLR and MHR are closely related to MCI in T2DM patients.The combination of NLR and MHR have certain efficacy in prediction T2DM with MCI.

Objective To explore the correlation of neutrophil/lymphocyte ratio(NLR),monocyte/high density lipoprotein cholesterol ratio(MHR)and mild cognitive impairment(MCI)in patients with type 2 diabetes mellitus(T2DM).Methods 159 T2DM patients hospitalized in the Department of Endocrinology,Affiliated Hospital of Xuzhou Medical University from February 2023 to April 2023 were selected.The subjects were divided into normal cognitive function(Con,n=72)group and MCI group(n=87)based on score of Montreal cognitive assessment scale(MoCA).NLR and MHR were calculated and compared between the two groups.Spearman correlation analysis was used to analyze the correlation between NLR,MHR and MoCA score.Logistic regression analysis of the factors influencing the association between T2DM with MCI.Receiver operator characteristic(ROC)curve was used to evaluate the predictive value of NLR and MHR for DM complicated with MCI.Results Compared with Con group,MCI group showed a significant increase in hemoglobin A1c(HbA1c),fasting plasma glucose,NLR,MHR,neutrophil count,monocyte count,serum creatinine,cystatin C,while high density lipoprotein cholesterol lymphocytes,visual space and executive function,naming,attention,language ability,abstract thinking,delayed memory,orientation and MoCA score decreased(P＜0.05).Spearman correlation analysis showed that there was a negative correlation between MHR,NLR and MoCA score,visuospatial and executive function,delayed recall and attention.Logistic regression analysis showed that NLR,MHR,HbA1c were all risk factors for MCI in T2DM.ROC curve analysis showed that the area under the curve of NLR combined with MHR for diagnosing T2DM with MCI was 0.872,with corresponding sensitivity of 81.6%and specificity of 87.5%.Conclusions NLR and MHR are closely related to MCI in T2DM patients.The combination of NLR and MHR have certain efficacy in prediction T2DM with MCI.

Objective To explore the correlation between thyroid antibody levels and early renal injury in patients with type 2 diabetes mellitus(T2DM)combined with Hashimoto's thyroiditis(HT).Methods A total of 375 T2DM patients hospitalized in The Affiliated Hospital of Xuzhou Medical University from January 2018 to December 2022 were selectedas the study subjects,and 197 healthy people were selected as the control subjects.The patients with T2DM were divided into simple T2DM group(n=191)and T2DM combined with HT group(HT,n=184).According to the urinary albumin/creatinine ratio(UACR)level,T2DM patients with HT were divided into microalbuminuria subgroup(MUAlb,30≤UACR≤300 mg/g,n=70)and normal albuminuria subgroup(NUAlb,UACR<30 mg/g,n=114).According to whether the thyroid antibody was positive,they were divided into thyroid peroxides antibody[TPOAb(+)]subgroup(n=56),thyroglobulin antibody[TGAb(+)]subgroup(n=40)and TGAb and TPOAb double antibody positive subgroup(n=88).Results Compared with the NC group,the smoking,drinking,urinary creatinine,alpha 1-microglobulin,UACR,FPG,HbA1c,LDL-C,TC,and TG in the HT and T2DM groups increased(P<0.05),while HDL-C decreased(P<0.05).Compared with the NUAlb subgroup,the MUAlb subgroup showed age,DM duration,FPG,HbA1c,TGAb,TPOAb,thyroid stimulating hormone(TSH)increased(P<0.05),while FT3 and eGFR decreased(P<0.05).Spearman correlation analysis showed that UACR was positively correlated with age,HbA1c,TPOAb,TGAb,TSH(P<0.01),and negatively correlated with FT3(P<0.01).The UACR of the TGAb(+)+TPOAb(+)subgroup was higher than that of the TGAb(+)and TPOAb(+)subgroups(P<0.05).Logistic regression analysis showed that TSH,TGAb,TPOAb,and HbA1c were risk factors for MUAlb,while FT3 was a protective factor for MUAlb.Conclusions In T2DM with HT patients with normal thyroid function,TPOAb and TGAb are closely related to the occurrence of early renal injury.

Since December 2019, novel coronavirus pneumonia (NCP) has been reported in Wuhan, Hubei Province, and spreads rapidly to all through Hubei Province and even to the whole country. The virus is 2019 novel coronavirus (2019-nCoV), never been seen previously in human, but all the population is generally susceptible. The virus spreads through many ways and is highly infectious, which brings great difficulties to the prevention and control of NCP. Based on the needs of orthopedic trauma patients for emergency surgery and review of the latest NCP diagnosis and treatment strategy and the latest principles and principles of evidence-based medicine in traumatic orthopedics, the authors put forward this expert consensus to systematically standardize the clinical pathway and protective measures of emergency surgery for orthopedic trauma patients during prevention and control of NCP and provide reference for the emergency surgical treatment of orthopedic trauma patients in hospitals at all levels.

Objective To explore the related factors and diagnostic criteria of perioperative myocardial infarction (PMI) after on-pump coronary artery bypass grafting(CABG).Methods 258 CABG patients were selected.The cardiac troponin-I in immediately,6,12,24,and 48 hours after surgery were measured.95 percentile (P95) was used as the boundary,any measured value greater than P95 was identified PMI,as group I(13 cases),the rest as group II(245 cases).The age,sex,cardiopulmonary bypass time,aortic corss-clamp time,LV ejection fraction,left ventricular end diastolic diameter,grafted vessels,left anterior descending coronary artery occlusion,recent myocardial infarction (<3 months),severe complex coronary artery disease and other risk factors that may lead to PMI were analyzed.The data were analyzed using Student's test for continuous variables and the χ2 test for discontinuous variables.Results P95 value was 3.47,the cardiopulmonary bypass time(t=3.268,P<0.05),aortic corss-clamp time(t=2.047,P<0.05),severe complex coronary artery disease between the two groups had statistically significant difference (χ2=19.846,P<0.05).Conclusion cTnI>P95 (3.47) indicates that the myocardium injury is serious,cardiopulmonary bypass time,aortic corss-clamp time and severe complex coronary artery disease are associated with PMI in patients undergoing CABG.

ABSTRACT:The guinea pigs were immunized by the Brucella vaccine through intradermal injections and the skin scratch respectively ,and then the immune effects of the two ways were evaluated .Serum samples were collected one month after the last injection and detected for the total IgG titer by interval ELISA .Cell‐mediated immune was evaluated by late‐onset hyper‐sensitivity .The guinea pigs were challenged with Brucella melitensis M5 ,and then were killed to isolated M5 from spleen of each guinea pig to compare the protective effects of two methods of immunization .The ELISA results showed that both of the two methods of immunization could induce strong humoral immune response ,and DTH response to Br‐PPD antigen were 100%in both methods .No significant difference in the immune protective effect of two methods was detected .Results of humoral im‐munity ,cellular immunity and protective effect showed the same effect by intradermal injections and skin scratches .

Objective To evaluate the relationship between the incidence rate of hepatic encephalopathy in patients with cirrhosis and the model for end-stage liver disease (MELD).Methods The total of 120 patients with decompensated cirrhosis were enrolled and followed-up.MELD score was obtained to observe the incidence of hepatic encephalopathy.Results The incidence of hepatic encephalopathy was 44.17％(53/120).MELD score in hepatic encephalopathy patients was significantly higher than that in none hepatic encephalopathy patients[(21.69 ± 9.22) scores vs.(9.32 ± 4.63) scores],and there was significant difference (P ＜ 0.05).With the increase of MELD score,the incidence of hepatic encephalopathy increased (P ＜ 0.01).The best critical value of MELD score was 14.13 scores (the sensitivity of 86.05％ and the specificity of 88.37％),when MELD ≥14.13 scores,the incidence of hepatic encephalopathy within 3 months was significantly higher [63.16％(48/76) vs.11.36％(5/44)] (x2 =30.32,P＜ 0.01).Conclusion MELD can help predicting the incidence of hepatic encephalopathy in decompensated cirrhosis patients.

OBJECTIVETo explore the feasibility and safety of scarless laparoscopic radical resection of rectal cancer.

METHODSClinical data of 26 patients who underwent scarless laparoscopic radical resection of rectal cancer from January 2011 to June 2013 were retrospectively analyzed. Lymph node dissection and transection of proximal and distal colon were performed in the conventional manner of total mesorectal excision (TME). The distal rectum 2 cm away from the tumor was closed with a linear stapler, and was pulled out through the anus. The specimen was extracted through the Alexis. The rectal opening was reclosed with a linear stapler. End-to-end colorectal anastomosis was performed using the double-stapling technique.

RESULTSThe operation time was (126±35) min. The intraoperative blood loss was (33±61) ml. The number of harvested lymph nodes was 17.0±5.6. The time to first bowel movement was (2.7±1.3) d. The postoperative hospital stay was (7.9±2.6) d. Only one case developed anastomotic hemorrhage.

CONCLUSIONScarless laparoscopic radical resection of rectal cancer is feasible.

Adult ; Aged ; Anastomosis, Surgical ; methods ; Female ; Humans ; Laparoscopy ; methods ; Lymph Node Excision ; Male ; Middle Aged ; Rectal Neoplasms ; surgery ; Retrospective Studies

Objective To explore the feasibility and safety of scarless laparoscopic radical resection of rectal cancer. Methods Clinical data of 26 patients who underwent scarless laparoscopic radical resection of rectal cancer from January 2011 to June 2013 were retrospectively analyzed. Lymph node dissection and transection of proximal and distal colon were performed in the conventional manner of total mesorectal excision(TME). The distal rectum 2 cm away from the tumor was closed with a linear stapler, and was pulled out through the anus. The specimen was extracted through the Alexis. The rectal opening was reclosed with a linear stapler. End-to-end colorectal anastomosis was performed using the double-stapling technique. Results The operation time was (126 ±35) min. The intraoperative blood loss was (33 ±61) ml. The number of harvested lymph nodes was 17.0 ±5.6. The time to first bowel movement was (2.7±1.3) d. The postoperative hospital stay was (7.9±2.6) d. Only one case developed anastomotic hemorrhage. Conclusion Scarless laparoscopic radical resection of rectal cancer is feasible.

Objective To explore the feasibility and safety of scarless laparoscopic radical resection of rectal cancer. Methods Clinical data of 26 patients who underwent scarless laparoscopic radical resection of rectal cancer from January 2011 to June 2013 were retrospectively analyzed. Lymph node dissection and transection of proximal and distal colon were performed in the conventional manner of total mesorectal excision(TME). The distal rectum 2 cm away from the tumor was closed with a linear stapler, and was pulled out through the anus. The specimen was extracted through the Alexis. The rectal opening was reclosed with a linear stapler. End-to-end colorectal anastomosis was performed using the double-stapling technique. Results The operation time was (126 ±35) min. The intraoperative blood loss was (33 ±61) ml. The number of harvested lymph nodes was 17.0 ±5.6. The time to first bowel movement was (2.7±1.3) d. The postoperative hospital stay was (7.9±2.6) d. Only one case developed anastomotic hemorrhage. Conclusion Scarless laparoscopic radical resection of rectal cancer is feasible.